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Is Caesarean section surge due to marketing or uninformed patients?
Official records show that delivery charges have nearly doubled in eight years mainly driven by demand for special services. PHOTO | FILE
Some time ago in a discussion about public health facilities and Kenyans’ perception on the services they offer a colleague dropped a comment that was intriguing; a Swedish royal family princess it seemed had just delivered in the equivalent of a public hospital.
This was a remarkable feat by comparison to Kenyan society where the elite never use public health services. The ongoing complaints about rising costs of maternity services in private hospitals as highlighted by sections of the media are a pointer to lack of confidence in our public health system.
According to a Daily Nation article a few of weeks ago, there seems to be a rise in the costs private hospitals charge for Caesarean section or CS deliveries. The figures given varied from Sh30,000 to Sh250,000, a big discrepancy by any statistical standards.
Quoting from an article in The Economist titled Caesars Legions, the magazine says: “The global rise of Caesarean sections is being driven not by medical necessity but by growing wealth — and perverse financial incentives for doctors”.
This elicited quite emotive comments from women, doctors, insurance companies and hospitals.
No doubt the popularity and cost of Caesarean sections is a hot topic globally. From an economic perspective, the surge in private hospitals’ fees for Caesarean section does not fit the conventional price versus demand curve. More women are using the same private facilities for the service despite their lamentations.
A health economics professor calls it one of the “illogical price curves” among health services consumers. He asks why patients would continue paying more for a service whose cheaper alternatives exist.
His conclusion is that either patients are unaware of alternatives such as the government’s free maternity scheme, or the services are not of the same quality.
I will point out a few facts. The first is that the government offers “free” CS delivery services to all Kenyan women. The second is that numerous other private hospitals offer CS services for much less.
Judging by the free maternity project’s advertisements however, it seems the first scenario is unlikely. The conclusion then could be that patients feel top tier facilities have a better product. Whether this is true or not should be put to question.
As opposed to other business enterprises, an emphasis on ethics and morality applies more to our businesses. On the ethical scale we gauge ourselves on whether the prices we charge are reasonable so as to include as many patients as possible.
On the moral aspect we ask if it is okay to charge for a service in the first place.
It would be immoral for private facilities to charge more for the same quality of service. It is, however, patients’ personal choice to pay more for the service if alternatives exist and they know about them.
If the quality is different, patients have no choice other than to pay a higher fee for the superior product. As an emotive public issue, however, it is time we looked at the topic in its entirety.
Why are private facilities deemed of higher quality and how do we make the services they offer affordable?
Similarly, how do we improve the quality of public facilities if they indeed are of a lower quality?
