On Movement Conservatism and Labor… (no, the other kind of labor)
Forgive me if I go a little regional:
For those that still believe that movement conservatives are anti-government and pro-free market except in very specific self-serving circumstances, I might recommend taking a look at the recent hubbub in my home state of Oregon as a fairly sound rebuttal. The source of our regional consternation? Early induced labor and c-sections.
I am really hoping Russell chimes in with his own commentary on the medical side of this issue, but until he does I will have to rely on my own limited understanding, which is largely derived from both the insurance side of things and the local papers:
As of September 1st of this year 17 of 53 hospital groups in Oregon have collectively agreed to stop inducing labor or scheduling c-sections prior to the 39th week of pregnancy unless there is a medical reason for doing so. This is no small deal. Even though “17 of 53” seems relatively small these include all of the hospitals in the Portland metropolitan area, which is by far Oregon’s largest population center. In fact, these 17 hospitals account for half of all Oregon births each year.
Up to now, it has been possible for either a doctor or a patient to request non-medically necessary induced labor or c-section in the 38th week. Most often, this request was done at the request of the physician and was done for scheduling reasons. Inducing labor can eliminate the possibility of being called in at night or on a weekend. In addition, it is cheaper for a hospital to induce labor just prior to due dates since they can then schedule births sequentially, which allows them to staff with fewer on-hand personnel. Mothers sometimes request inducing at 38 weeks as well, mostly for their own scheduling reasons. (The Portland Tribune reports that some mothers have had early inducements or c-sections to have their babies on specific dates that have personal meaning. I will have to take their word for this, but confess I’d never heard of such a thing prior.)
And maybe some Mothers just want to get the damn pregnancy over with.
The reason for the change from 38 to 39 weeks? Basically, it’s the hippocratic oath.
Growing data shows that there is significant brain development that continues through the 38th week that can be adversely affected by early labor and delivery. Also, babies that are voluntarily induced or c-sectioned for non-medical reasons prior to week 39 are between 2 to 3 times more likely to be admitted to intensive care. They also have significantly higher rates of serious post-natal breathing issues that can threaten both the newborn’s life and potential cognitive ability.
Oregon is not the first place providers have made this change (though I believe ours is the first group of separate entities to do so collectively). Intermountain Healthcare – a private, non-profit hospital group in Utah and Idaho – made the change a few years ago. That change is credited in a reduction of 500 newborns needing to be put on ventilators annually, for an estimated cost savings of over $1 million per year.
I want to be very clear that the decision the 17 Oregon hospital groups made was not due to any legislative or governmental rule change; nor were they succumbing to pressure from any governmental regulatory body. This was a voluntary change that 17 of 53 hospital groups made. Their decision was based entirely on issues related to health and wellness, cost, and risk management.
Also, please remember that this new voluntary policy still allows for any early inducement of labor or c-section if the doctor believes there is or may be a medical reason relating to the health and well being of the mother or unborn child.
In another alternate universe, local movement conservatives would hail this as a triumph of the free market finding solutions without government interference.
Oh, that this was that alternate universe.
The voices of movement conservatism in our state are already out to put a stop to this “travesty,” and it has become a hot topic on local and regional talk radio. I have started to hear movement conservatives here call for regulations that would forbid private hospitals from making such decisions. The hospitals’ very ability to make these changes in their own policies and procedures is being called un-American. Tea Party darling and talk radio host Lars Larson (who does both a regional and national show daily) spoke about the issue on Friday; while acknowledging these were private companies, he justified some kind of interference because “sometimes they might get Federal money, and they get a lot of our insurance money.” He and others have even taken to calling the decision by the hospitals an intrusion of Obamacare, even though the two are not related (except in the expansive “they both have to do with health care” kind of way). I should also note that in the conservative media’s treatment of this story, the reasons behind the voluntary change – despite these being part of news reports they otherwise quote – are never mentioned. Instead, it is simply insinuated that President Obama (no, really) has stepped in and is taking away the ability for a doctor and patient to agree on treatment.
I am not so much of an idiot that I don’t get the reason why this might be a “pressing” issue for Oregon conservatives, especially those in the local media and small-potato elected seats. It’s being raised as a test balloon on regional and small-fish national shows to see if it can get any traction. If it can, we will soon be hearing about this story on Limbaugh, reading about it on Drudge, seeing it on Hannity, and the local pols and pundits will get their 15 minutes of fame in the big-kid Guest Chair. If it can’t get traction, it’ll just be quietly thrown onto the trash heap of non-troversy wanna-bes and replaced by another silliness tomorrow. (Though months down the road local radio-listeners will vaguely remember that Obama wanted to take their babies or something.)
I think it is still worth noting, however, how little those that claim to be the champions of the free market actually care about it if they can score an amaaaaazingly small political point, or if they can force such a wee cry of outrage at the system.
In other words, what is most galling to me about this story isn’t that movement conservatives are willing to throw the free market under the bus; it’s how little it takes to get them to do so.