By james art 
A pregnant woman is waiting to be examined by her Ob-Gyn at the Hyali Community Health Center, Florida recently became the first state to authorize the caesarean sections in clinics outside hospital people. (Joe Raedle/Getty Images)
Recently passed a law in Florida, which allows doctors to deliver babies through caesarean section to clinics outside hospitals, it can be a plan for other states, even when critics indicate the role that a group supported by private capital has been involved.
The United States has poor mother health results compared to peer peers, and hospital labor and delivery wards are closed throughout the country due to financial tension. Proponents claim that Florida’s law can increase access to maternity care and more expenses to expect patients.
But critics, including some medicines, hospitals and midwives, warn that it is an unprecedented model that can put the health of mothers and babies at risk. They also note that private capital companies, which have made other healthcare raids, have attracted state control over the alleged profit assessment due to patient safety.
Alex Borsa, a researcher at Columbia University, whose published work focuses on the impact of private capital on healthcare, said she was not surprised that Florida had become a test platform for such clinics.
“In addition to Florida, which is the Wild West in a number of political directions, it has one of the highest concentrations of state operators, supported by private capital, including OB-GYN and fertility,” the Borsa said.
Traditional birth centers are usually a staff of midwives who provide care for maternity pregnancy and low -risk births. Twenty -nine such centers work in Florida and about 400 are licensed throughout the country. The focus in these centers is on natural birth in a home setting, where women work without anesthesia and deliver babies vaginally.
Florida’s law creates a new designation called the Advanced Birth Center, which allows doctors to offer labor and delivery services to a free -standing clinic, including delivery from Caesarean section. There are currently no such centers. A C-section is a surgical procedure performed with anesthesia in which the baby is delivered by incision to the patient’s abdomen and uterus. C-sections are usually reserved for situations where a doctor believes that vaginal birth may be risky for the mother or baby.
We are against him because you call Lion Tiger.
– Kate Bauer, CEO of the American Birth Centers Association
Prior to passing the law last spring, C-sections can only be performed in hospitals that have staff and equipment intended for surgery and potential complications.
But a private group owned by the capital called women’s care companies in recent years has been lobbing Florida legislators for the new designation. The London -based investment company BC Partners has operated about 100 clinics in Florida and a dozen more in Arizona, California and Kentucky.
The new designation was brought into a largest law of health policy and has become a law, despite the opposition of medical and obstetric groups.
“Both mom and baby deserve access to the best possible care, which is why we believe that C-sections should be performed exclusively in the hospital setting where doctors, multidisciplinary teams, complex equipment and other critical resources are available immediately in the events complications They are arising, “the President and CEO of the Florida Hospital Mary Maichu told Stateline in a statement.
But the Association does not fight the bill that, among other things, increases Medicaid payments in hospitals for maternity care. Other groups opposed.
“We are mostly opposed to this because you call Lion Tiger,” says Kate Bauer, CEO of the American Birth Centers, a non -profit purpose that sets national standards for birth centers.
She noted that while advanced birth centers will offer maternity care outside the hospital setting, they are not the same as the traditional birth centers based on midwives. The births visited by the midwife are for people with low -risk pregnancy and tend to focus on low intervention care and emphasize natural birth techniques. Births visited by a doctor tend to rely on more advanced medical interventions, such as epiduras and labor-causing drugs.
Private capital jumps
Florida legislators, supporting the new designation of advanced births, said it has the potential to increase access to maternity care in undervalued areas and reduce costs. Only two of the 22 rural hospitals in Florida have work and delivery services.
The staff of the State Senator Florida Gayle Harel, the Republican, who sponsors the bill, told Stateline that he was not available to comment on it. But in the previous hearing of the committees, Republican legislators declared the centers as an innovative obstetric decision.
“I think what we hear from our medical community is the desire for options,” said state senator Republican Colin Burton, a Republican, at a hearing of the Committee of December 2023 on the bill. “And what we particularly hear from are patients, from the Floridians, [who want] Options. And potentially this can provide an option with a lower price. “
But critics question whether Ob-Gyn, already in shortage in Florida, will probably open advanced birth centers in low-income and rural communities, where a larger share of patients has Medicaid. The government-sponsored insurance reimburses to doctors significantly less for maternity care than private insurance.
The Stolombian University Exchange, co-author of a 2020 survey, which found that private equity-owned offices were more likely to be located in urban areas with medium-sized households over the country’s average.
Private capital companies use joined money from investors to buy control bets in companies. They usually focus on raising the value of a company before selling it within a few years, ideally with profit. Over the past decade, private capital investors have spent $ 1 trillion acquired health companies.
The Exchange said that he and his colleagues have found serious evidence that the involvement of private capital in healthcare “much consistently increases the cost of patients and payers.”
“There is a fantasy that investors in Wall Street will somehow increase access to some of the countryside and poor parts of the country, but we have not seen evidence of it,” he said.
In recent years, the participation of private capital in the health industry has attracted public control and legislative control. Earlier this month, for example, the US Senate Budget Committee publishes a report that details how hundreds of millions of hospitals have been ignited by private capital companies.
Dr. Helen Kuroki, the Chief Medical Officer of Women’s Care Businesses, declined to comment on his support for the new law and when he could open an advanced birth center. Earlier, representatives said they were looking for a center in Tampa or Orlando.
Work and delivery services tend to be financial losses for hospitals, thanks to low recovery rates, especially from Medicaid. In rural areas, where Medicaid covers up to half of all births, recovery does not cover the full price for the provision of obstetric services.
If patients covered by better paid private insurance flow to free-standing birth centers that can carry out C-sections, this would leave hospitals with a larger share of patients with Medicaid. And possessing the surgical space would allow doctors to doctors such as women’s care enterprises to keep more than dollars for recovery that usually go to hospital.
As surgical centers – something like
Proponents have compared the new Florida birth model with outpatient surgery centers where patients are undergoing surgical procedures that do not require hospital stay overnight. Patients who undergo C-sections will be able to stay at night in the new birth centers.
But critics say the C-section is inherently different from, say, cataract surgery or tonsillectomy.
“We have seen outpatient surgical centers be a successful model of health care,” says Bauer of the Birth Centers Association. “For me, the main difference is that surgical birth is the only surgery where when you are done, you have an extra person. And this is an additional person whose health can be compromised. “
Some Florida MPs have expressed concern that the new centers will not be required to have pediatric specialists on hand to take care of a baby if there is a problem after birth. The centers are obliged to have a written agreement with a local hospital to transfer patients with complications. And they also need to comply with most of the safety standards of outpatient surgical centers.
So far, Florida remains appearance. Legislators in other countries have not yet introduced such bills.
But since private capital companies deepen their involvement in women’s health and other health sectors, the stock exchange expects them to improve their lobbying as state legislators in order to gain favorable changes in politics.
“We can see more lobbying health care, and in particular around this number in other parts of the country,” he said. “I don’t think it’s one -off, especially if they find that they can get profits.”
Stateline is part of States Newsroom, a non -profit news network, supported by grants and a donor coalition as a public charity 501C (3). Stateline maintains editorial independence. Contact the editor Scott S. Greenberger for questions: [email protected].