The health insurance system is complicated. Obamacare has become the closest this country has come to health insurance for the masses. The Universal Healthcare, or "free healthcare" of European nations requires both higher tax input by the people and government support. This is not likely to occur in the United States, where private business and lower taxes are valued. Yet, many more people are insured under Obamacare, which is a good thing.
We all expect that our insurance plans will pay for our healthcare. Yet the paradigm of the healthcare system is that 'more is better.' Therefore, there are larger healthcare groups forming. In this 'system' we often see our providers for short visits and the care is often impersonal. Insurance companies may negotiate with a medical group that if they become in-network providers they will agree to accept a lesser fee in exchange for more 'patients.' More is considered desirable within this paradigm.
Homebirth does not fit into this systemic paradigm. We are small practices, offering personal care, where you, the 'client,' is treated as an empowered participant of your care throughout the childbearing year. Our style of care does not fit into the larger medical paradigm. Often insurances are paying less, taking longer to provide reimbursement for care, all of which makes maintaining a small homebirth practice less-than sustainable.
In some ways the personal, family-centered, and, hopefully, affirming and empowering care you seek when choosing to birth at home resembles how we mark life transitions---weddings, birthdays, anniversaries, bar mitzvahs, naming ceremonies--- rather than health 'procedures.' In that way we must re-think how we consider payment for homebirth. If homebirth is to be sustainable in a culture that does not recognize it as a respectable and healthful option, we all need to consider how we can pay for it if insurance plans do not.
I tell this 'story' of the health insurance conundrum at each interview. I, Marcy Tardio, and now Tanya Wills, midwives of this practice, are committed to providing homebirth care for the families that seek our care. We must all continue the conversation and think outside the proverbial box when the insurance system and varied plans do not pay a sustainable fee so that homebirth remains available to all who seek this important type of care.