如今，美国女性一个月的收入还不够生个孩子的

如今，美国女性一个月的收入还不够生个孩子的

A new study revealed that the cost of childbirth has become exorbitant for many mothers — regardless of insurance status. Researchers found that pregnant women with employer-provided health insurance spent an average of $4,500 out of pocket in 2015, the most recent data available.

一项新的研究显示，对许多母亲来说，不管是否有保险，生育的费用已经变得过高。研究人员发现，根据现有的最新数据，2015年，拥有雇主提供的医疗保险的孕妇平均支出为4500美元。

That’s a 50% spike compared with 2007, when the cost was about $3,000 out of pocket — and more than three times the rate of inflation during that period.

与2007年相比，这一数字增长了50%，当时的成本约为3,000美元，是同期通胀率的三倍多。

“I don’t know a lot of patients who have this kind of funding lying around,” Dr. Michelle Moniz, a physician and assistant professor at the University of Michigan and study author, told CBS News.

“我不知道有多少人有这样的资金，”密歇根大学(University of Michigan)的助理教授、该研究的作者米歇尔·莫尼兹(Michelle Moniz)博士告诉CBS新闻(CBS News)。

“These expenses are coming at a time when most of my patients are thinking of everything else on their baby list,” she added, “a crib, a car seat, everything they need to keep their newborn safe — and they aren’t expecting a bill like this.”

她补充说:“这些费用是在我的大多数病人都在考虑他们的婴儿清单上的其他东西的时候出现的，一个婴儿床，一个汽车座椅，他们需要的一切来保证他们新生儿的安全——他们没有料到会有这样一笔账单。”

The study, published this week in Health Affairs, included birth records from more than 650,000 women who would be considered in the best position to give birth, thanks to their large employer-sponsored health insurance plans, which typically offer more cost coverage than plans through small businesses or those purchased independently through HealthCare.gov.

这项研究发表在本周的《健康事务,包括出生记录来自650000多个女性会被视为生在最好的位置,由于大量的雇主赞助的健康保险计划,通常提供更多的保险成本比计划通过小企业或通过HealthCare.gov独立购买。

The cause of the increase isn’t due to the rising cost of hospital care. In fact, the actual billed amount for childbirth remained fairly steady over the seven-year study period. Instead, researchers found that deductible payments rose from about $1,500 to nearly $2,500, while coinsurance costs (what the patient pays after meeting their deductible) increased by about $300.

增长的原因不是由于医院护理费用的增加。事实上，在七年的研究期间，分娩的实际账单金额保持相当稳定。相反，研究人员发现，可扣除的费用从约1500美元增加到近2500美元，而共同保险费用(病人在达到可扣除费用后支付的费用)增加了约300美元。

“I was completely surprised that the phenomenon of having to pay something out of pocket for maternity care was almost universal,” said Moniz. “98% of people had some out-of-pocket cost by the end of the study.”

莫尼兹说:“我非常惊讶，几乎所有的产妇护理都是自费的。”“到研究结束时，98%的人都有一些自付费用。”

For those without insurance, the cost is staggering. Health-care watchdog Fair Health found that the average cost of vaginal birth without insurance in Alabama, where childbirth costs are lowest, is $9,516.86. On the high end, in Alaska, a natural birth averages $20,243.38. Women who require a C-section can count on paying approximately $4,000 to $8,000 more.

对于那些没有保险的人来说，费用是惊人的。卫生保健监督机构Fair Health发现，在分娩成本最低的阿拉巴马州，没有保险的顺产平均成本为9,516.86美元。在阿拉斯加，自然分娩的平均费用是20,243.38美元。需要剖腹产的女性可以多支付大约4000至8000美元。

Study authors call out the Affordable Care Act (ACA), which requires employer-based insurance plans to cover maternity services, pointing out that just because it’s now mandatory doesn’t mean it’s more affordable.

研究报告的作者们指出，《平价医疗法案》(ACA)要求以雇主为基础的保险计划来覆盖生育服务，并指出仅仅因为它现在是强制性的并不意味着它更容易负担。

“For people who talk about the ACA, there seems to be this misconception that ‘oh, maternity’s covered,’?” said Moniz, who wrote in her report that those plans are being allowed to “impose cost-sharing such as copayments and deductibles.”

莫尼兹在她的报告中写道:“对于那些谈论ACA的人来说，似乎有一种误解，认为‘噢，产假有保障’。”

That’s especially concerning considering pregnancy-related deaths are also on the rise, especially among black and other minority women. A 2019 report by the Centers for Disease Control and Prevention noted that US women today are 50% more likely to die of childbirth-related complications than a generation ago.

尤其是考虑到与怀孕相关的死亡人数也在上升，尤其是在黑人和其他少数族裔女性中。美国疾病控制与预防中心(Centers for Disease Control and Prevention，简称cdc) 2019年的一份报告指出，与上一代人相比，如今美国女性死于分娩相关并发症的可能性增加了50%。

“Our hope is that policymakers take note now and change the situation,” she added. “We want every family to get off to the best start in life, and this is an irremediable barrier.”

她补充道:“我们希望政策制定者现在注意到这一点，并改变这种状况。”“我们希望每个家庭都能有一个最好的开始，这是一个不可逾越的障碍。”