Haley Marie is Born

I am writing this column just a few hours after the birth of my second grandchild, Haley Marie.  Haley Marie looks like her father.  She is long and thin, and she is going to be very pretty when she is older.

Our first grandchild, Noah, was born four months ago.  He’s in the 5^th percentile in weight, and my wife and I joked that it would be hard for Haley to beat that when she came along.

She did.  She weighed in at two pounds and eleven ounces, which means that, according to the Annie E. Casey Foundation Kids Count project, she is one of the 1.5% of all U.S.  babies who are born each year at “very low birth weight,” or less than 1500 grams (3 pounds, 4 ounces). 

So Haley Marie will spend her first days in a hospital neonatal intensive care unit. 

Haley is fortunate.  She was beyond thirty-two weeks of gestation.  Her Apgar scores were stellar.  She is strong and has good lungs.  I can also offer direct testimony that she is alert and responsive to light.  I learned this when I snapped a picture of her at five hours without turning my camera flash off!

But not every baby born at very low birth weight gets off to as good a start as Haley.

We all say we care for babies, but here is something we don’t like to mention:  low birth weight babies have a higher risk of dying.  Very low birth weight babies have a 24% chance of dying during their first year of life.

I’m a worrier by nature.  So statistics like this have always worried me.  Even before there were children and grandchildren in my life back when I was a state legislator, I stressed constantly over how to help reduce our too-high infant mortality rates.

Prevention and good prenatal care are answers.  But sometimes – as in Haley’s case – a baby is born at low birth weight even though her mom has taken good care of herself during pregnancy and received high quality prenatal care.

Neonatal intensive care, thankfully, is another answer.  But neonatal care is expensive. 

In 2005, the Institute of Medicine found that most of the $26 billion annual cost of premature birth  - or over $51,000 per child – was for neonatal intensive care.  Haley’s parents can’t afford this, nor could most of us.

Thank goodness we have insurance to pick up the slack.  But relying on private insurance to pay our neonatal intensive care bills is a double-edged sword.  Insurers often charge hefty co-pays, and the amounts can change unpredictably.  As Michelle Andrews pointed out in an article in Kaiser Health News in January, 2011, “fewer parents-to-be realize that they may be in for a nasty surprise if their baby is premature or for some other reason needs special care immediately after birth: The neonatal intensive care unit (NICU) personnel at their in-network hospital may be out-of-network.”

Here’s something that may offend some people, but I’m going to write it anyway:  Relying on private insurance alone to pay for health care is too big a gamble when children’s lives are at stake. 

It’s a good thing many children have the security of a public option, too.  Shame on the politicians who say they have a problem with this, and want to roll back or block grant Medicaid or SCHIP funding at Haley’s expense.

They have never walked in her tiny shoes; I hope they never even have to walk in mine.

The NICU providing care to Haley today was also built in large part through the investment of hundreds of millions of taxpayer dollars beginning fifty years ago.  I’ve lost faith that the “tax cuts at all costs” politicians of today would have the backbone to launch a similar project.

And for this Haley’s granddaughter could someday pay a price.

As a group, children born at very low birth weight face more challenges as they grow up.  According to Child Trends, they are more likely to have chronic health conditions and developmental delays.  They are also more likely to need special education services.  They are at greater risk of dropping out of school, and have lower earnings potential.

I’m not going to think about all this today, however.

Haley, I am sure, will be just fine.  So I’m just going to celebrate the miracle that is her life.

And acknowledge with gratitude the governments that protect us all, especially those, like Haley, who are most in need.

If you have questions about this column or wish to receive an email notifying you when new Our Health Policy Matters columns are published, please email gionfriddopaul@gmail.com.

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