Comments on: John Edwards, C-Sections, and Childbirth Deaths http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/ Cleaning the Augean Stables of the Health Care Debate Fri, 09 Jan 2009 01:26:28 +0000 http://wordpress.org/?v=2.3.3 By: Catron http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5948 Catron Mon, 27 Aug 2007 20:31:41 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5948 No, I'm afraid you don't get it. No, I’m afraid you don’t get it.

]]> By: Marc Brown http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5947 Marc Brown Mon, 27 Aug 2007 20:20:23 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5947 Ah, I get it - they up the c-rate to cover their costs. Thanks for making that clear. Ah, I get it - they up the c-rate to cover their costs. Thanks for making that clear.

]]> By: Catron http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5940 Catron Mon, 27 Aug 2007 17:16:24 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5940 “Reimbursement” does not equal profit, Marc. What you get paid has meaning only in relation to your costs. I guess you aren’t familiar with the term “contribution margin” that I used <a href="http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5909" rel="nofollow">above</a>. <a href="http://en.wikipedia.org/wiki/Contribution_margin" rel="nofollow">Here’s</a> a link that explains it. “Reimbursement” does not equal profit, Marc. What you get paid has meaning only in relation to your costs. I guess you aren’t familiar with the term “contribution margin” that I used above. Here’s a link that explains it.

]]> By: Marc Brown http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5939 Marc Brown Mon, 27 Aug 2007 17:06:19 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5939 have a read of this: http://cfmidwifery.org/Resources/Item.aspx?ID=32 ‘The fact that more cesarean sections are performed when reimbursement is higher, shows that this intervention is done at least some of the time for economic reasons. For example, in 2000 cesarean sections were performed on 24.4% of patients covered by private insurance (which reimburses at the highest rates), on 20% of patients covered by Medicaid, and on 18.65% of women who were uninsured (”Care of Women in U.S. Hospitals, 2000″ HCUP Fact Book No. 3).’ have a read of this:

http://cfmidwifery.org/Resources/Item.aspx?ID=32

‘The fact that more cesarean sections are performed when reimbursement is higher, shows that this intervention is done at least some of the time for economic reasons. For example, in 2000 cesarean sections were performed on 24.4% of patients covered by private insurance (which reimburses at the highest rates), on 20% of patients covered by Medicaid, and on 18.65% of women who were uninsured (”Care of Women in U.S. Hospitals, 2000″ HCUP Fact Book No. 3).’

]]> By: Catron http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5929 Catron Mon, 27 Aug 2007 12:21:14 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5929 Nice try, Marc. Switching the burden to me won't get you off the hook on your “more profitable” claim. Nice try, Marc. Switching the burden to me won’t get you off the hook on your “more profitable” claim.

]]> By: Marc Brown http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5923 Marc Brown Mon, 27 Aug 2007 09:28:02 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5923 And you have offered nothing on the number of c-sections performed because of potential litigation. Where is your objective data, David? Also is Tonya Jamois, president of the International Cesarean Awareness Network, really an ill-informed windbag? Would you like to explain? I note too you linked to the Ann Coulter 'faggot' comment on John Edwards - what is your reason for this? And you have offered nothing on the number of c-sections performed because of potential litigation. Where is your objective data, David?

Also is Tonya Jamois, president of the International Cesarean Awareness Network, really an ill-informed windbag? Would you like to explain?

I note too you linked to the Ann Coulter ‘faggot’ comment on John Edwards - what is your reason for this?

]]> By: Catron http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5913 Catron Mon, 27 Aug 2007 01:57:29 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5913 <em>Can you point to any case of Edwards’ where the verdict was not supported by the facts of case? </em> Yep. In his most famous case, he convinced a jury that a C-section would have prevented a case of cerebral palsey. But there is no credible scientific data showing that the incidence of cerebral palsy is affected by the C-section choice one way or the other. <em>It’s interesting how loose you are with statistics that even imply they support your preconceived notions, but are terribly skeptical of those that don’t.</em> No one in this comment stream has produced any statistics. All Marc offered was the gratuitous assertion of an ill-informed windbag. Can you point to any case of Edwards’ where the verdict was not supported by the facts of case?

Yep. In his most famous case, he convinced a jury that a C-section would have prevented a case of cerebral palsey. But there is no credible scientific data showing that the incidence of cerebral palsy is affected by the C-section choice one way or the other.

It’s interesting how loose you are with statistics that even imply they support your preconceived notions, but are terribly skeptical of those that don’t.

No one in this comment stream has produced any statistics. All Marc offered was the gratuitous assertion of an ill-informed windbag.

]]> By: Matt http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5912 Matt Mon, 27 Aug 2007 01:25:02 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5912 Catron, Can you point to any case of Edwards' where the verdict was not supported by the facts of case? It's interesting how loose you are with statistics that even imply they support your preconceived notions, but are terribly skeptical of those that don't. A bit hypocritical, don't you think? Catron,

Can you point to any case of Edwards’ where the verdict was not supported by the facts of case?

It’s interesting how loose you are with statistics that even imply they support your preconceived notions, but are terribly skeptical of those that don’t. A bit hypocritical, don’t you think?

]]> By: Catron http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5909 Catron Sun, 26 Aug 2007 23:42:00 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5909 Perhaps you should look up the definition of objective data (hint: the above quote doesn't qualify). The reality, Marc, is that C-sections have a lower contribution margin than vaginal deliveries. Perhaps you should look up the definition of objective data (hint: the above quote doesn’t qualify).

The reality, Marc, is that C-sections have a lower contribution margin than vaginal deliveries.

]]> By: Marc Brown http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5907 Marc Brown Sun, 26 Aug 2007 22:22:05 +0000 http://www.healthcarebs.com/2007/08/25/john-edwards-c-sections-and-childbirth-deaths/#comment-5907 'First, “hospitals” don’t decide whether or not to do C-sections. Physicians make that decision.' You're being pedantic. Hospitals are inanimate objects - of course it's people who make decisions. 'Second, please produce some (objective) data suporting your “more profitable” assertion.' Since when has objective data bothered you? How about you go first with your objective data on how many 'physicians are doing more C-sections to protect themselves from potential lawsuits'? But for now I'll say that as i've said before the US is the world leader in unnecessary overtreatment, and quick search reveals: 'A healthcare organization’s financial status may also play a role in the decision-making process. “Obstetricians and hospitals have found that high-intervention birth, warranted or not, is very profitable,” Jamois says. “So there is a tremendous financial incentive to bypass the clinically optimal approach, and opt for convenience and profit. For example, many hospitals across the country have eliminated facility-based midwifery practices simply because the low-intervention approach, while clinically sound, does not bring in as many dollars.”' From http://www.fortherecordmag.com/archives/ftr_082905p34.shtml ‘First, “hospitals” don’t decide whether or not to do C-sections. Physicians make that decision.’

You’re being pedantic. Hospitals are inanimate objects - of course it’s people who make decisions.

‘Second, please produce some (objective) data suporting your “more profitable” assertion.’

Since when has objective data bothered you? How about you go first with your objective data on how many ‘physicians are doing more C-sections to protect themselves from potential lawsuits’?

But for now I’ll say that as i’ve said before the US is the world leader in unnecessary overtreatment, and quick search reveals:

‘A healthcare organization’s financial status may also play a role in the decision-making process. “Obstetricians and hospitals have found that high-intervention birth, warranted or not, is very profitable,” Jamois says. “So there is a tremendous financial incentive to bypass the clinically optimal approach, and opt for convenience and profit. For example, many hospitals across the country have eliminated facility-based midwifery practices simply because the low-intervention approach, while clinically sound, does not bring in as many dollars.”’

From http://www.fortherecordmag.com/archives/ftr_082905p34.shtml

]]>