Helping Babies to Live
A child born in any of 16 other industrial nations has a better chance of living to its first birthday than a child born in the United States. In addition, infant-mortality statistics have not improved in this country since 1980. Why that is true and how to change the situation are the focus of a chilling report from the Congressional Office of Technology Assessment.
No one should have to talk dollars and cents when it comes to trying to save the lives of the 40,000 babies who die before their first birthday each year. That’s about 1% of all babies born in the United States annually. But OTA did just that to make the point that preventive medicine pays off for people who may look only at the bottom line instead of at the need to reduce suffering.
Most often babies die because they don’t weigh enough at birth to thrive--that is, they weigh less than 5 pounds, 8 ounces. That often happens because they are born prematurely; their mothers don’t know how to take care of themselves during pregnancy or don’t realize that they have health problems that affect an unborn child. If women visit a doctor regularly during pregnancy, some of these problems can be prevented so that they have a better chance of having a baby that can survive.
The congressional researchers found that $14,000 to $30,000 is saved each time a newborn infant can survive without intensive hospital treatment and long-term care. But many women can’t afford good prenatal care. Many don’t have health insurance or aren’t covered by the Medicaid program. If Medicaid coverage were expanded to all pregnant poor women, about 194,000 more women would be eligible for good care. That would cost $4 million a year.
Here’s where the saving comes in. If $14,000 to $30,000 is saved each time an infant doesn’t require intensive care at birth, then only 133 to 286 low-weight births have to be prevented to break even. And the evidence is convincing that earlier prenatal care makes that kind of reduction “quite feasible,” the study said.
Babies can also be helped to better lives through screening early in their lives for disorders like phenylketonuria (PKU), which leads to mental retardation, as well as for congenital hypothyroidism, sickle-cell anemia and cystic fibrosis. Even a modest PKU and hypothyroidism screening program involving the testing of only one blood specimen saves almost 1,300 infants from lifetimes of severe disability. It also saves the U.S. healthcare system about $120 million a year.
A complete program of shots for children provides what the researchers called “the starkest example of the power of prevention to save or prolong lives (and) prevent significant disability.” It, too, saves money, yet federal investment in immunization programs lags seriously.
Why, with these programs and techniques available, aren’t infant-mortality figures improving? Attempts are made to save more of the tiniest babies today than ever before, the researchers said, so that may skew the figures. But in addition the federal government simply has not undertaken a real effort to make sure that poor women and their children get decent health care. Cutting funds at the very time poverty is increasing raises the risks that babies will die, the report said.
Of course people want babies to live. But neither Washington nor Sacramento is trying to make a public case for the importance of the mission or for advancing the money needed to start reducing the infant-mortality rate. Now the Office of Technology Assessment has pointed to areas in which what’s good for babies is good for the budget. That is a true investment in the future, and one that any humane and prudent government should make.
