…it is not known how much of the overall increase in Caesareans is because of a rise in unnecessary operations, or how many Caesareans are done at the mother’s request, according to a 2006 report by the National Institutes of Health.
“I think it’s really a very small amount, but we need more data,” said Dr. Mary D’Alton, chief of obstetrics and gynecology at Columbia University Medical Center, and an author of the report.
She said she was amazed to hear that insurers would charge higher premiums or deny coverage because of a past Caesarean.
“I would think if it’s happening, the medical profession has to take a stand,” Dr. D’Alton said.
But to people familiar with the rough and tumble world of individual insurance, the companies’ practices are no surprise.
Individual insurance differs sharply from the group coverage with which most people are familiar. Group policies generally require that the insurer cover everybody in the group, and charge the same rates for all. But with individual coverage, insurers in many states can vary their prices based on medical history, exclude certain services or reject anyone they consider a bad risk. (Several states, however, including New York, New Jersey and Massachusetts, ban such practices.)
Insurers say they need these strategies to protect themselves, because some customers apply only after they get sick or pregnant, skewing the pool toward people with high expenses.
Read it all, also from the front page of this morning’s New York Times.