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A few hours after my daughter, Penelope, was born, a nurse came into the hospital room and asked my wife, Kate, and me if we wanted to have the baby taken to the nursery for a bit so we could get some sleep. Bleary-eyed and groggy after a long labor, we thought that was a fantastic idea. But we didn’t think so later on when we got a $1,420 bill for the nursery.

I saw red. Not just because $1,420 was equal to our monthly rent at the time, but also because we were being charged at all for Penelope’s two-hour stay in the nursery, a charge the nurse never mentioned.


Had she told us at the time that the nursery stay would cost several hundred dollars, we would have kept Penelope with us and I would have watched her myself so Kate could sleep. Looking back, it feels like a corrupt transaction.

To be clear, I don’t think the nurse was trying to pull one over on us. But I do think the hospital’s bureaucracy was.

I paid the bill — directly — given that we had a high-deductible plan. Maybe in hindsight I shouldn’t have. But I work a lot and would have found it hard to make the time to fight the bill.


As part of my job at the storytelling radio program “Our American Stories,” I’ve been working on a series called “What Happens When.” It’s about patients’ interactions with the health care system. A colleague encouraged me to dedicate the time — during work hours — to investigate that absurd nursery bill.

I called the hospital, Baptist Memorial — the only hospital in our town of Oxford, Miss. (which explains a lot of this) — with one simple question: Exactly what was included in that $1,420 nursery charge?

I had to call nine people to get an answer.

What I finally learned was that a newborn’s stay in the nursery costs $710 an hour. Penelope was there for about two hours, ergo the $1,420.

Let’s put that $710-an-hour charge into context. At home, we usually pay a babysitter $13 to $15 an hour. The average nurse makes $33 an hour, which is just about what I get paid. And the average doctor makes about $80 an hour.

If the hospital babysitter was to work full time at the rate Kate and I paid, she or he would make more than $1.4 million a year!

To be sure, the hospital must charge several times what a nurse is paid to watch a baby in order to keep the lights on, maintain the building, and do all the other things that go into running a hospital. But 21 times more? That’s not justifiable.

When I pointed out to one official that the hospital couldn’t reasonably think that I’d want to pay $710 for a babysitter to watch my child, she responded, “Well, it’s not a matter of watching, they have other things that they do.”

My story of this crazy hospital charge — and others’ stories of them — will keep happening as long as the following remain true.

  • There is a lack of competition between hospitals for our dollars, and we have hospital monopolies like Baptist Memorial. The only area of health care in which the price goes down over time is pharmaceuticals. That’s because of the presence of vigorous competition through the introduction of generic versions of brand-name drugs.
  • We continue to be lulled into an insurance-pays-for-everything mindset that makes it easier for health care providers to get away with not telling consumers the actual price of a service. Insurance is supposed to be for catastrophic events; we don’t use our car insurance for oil changes.
  • Hospitals aren’t up front about what they charge you for. It’s morally wrong for a hospital to charge you $1,420 for a service you clearly would have said no to if someone had been straight with you instead of pretending it wasn’t going to cost anything.

This was an expensive lesson for Kate and me that we need to be more proactive about asking what various hospital services cost, especially those that are “elective,” like Penelope’s stay in the Baptist Memorial nursery. I hope that you will do the same and see through any cost obfuscation.

Alex Cortes is the vice president of content development at “Our American Stories,” a nationally syndicated storytelling program. This article is adapted from his audio story, “An Investigation: The Most Expensive Babysitter in the World.”

  • This is why we need to forego tax breaks for these people. This is why patients, not admin, need to be in charge of these places. Government is not doing its job to rein them in and all the amassing revenue hospitals are doing is buying lobbyists and govt. laws to protect them. They are no different than the robber barons of yester year.

  • Congratulations, Mr. Cortes, on the birth of your daughter! While your wife came into the hospital as one person once your daughter was born, there are now two patients to care for. The transition from intrauterine life to extrauterine life is one of the biggest undertakings we undergo as human beings. The bill you are describing is the cost of caring for your daughter as a patient. The billing requires it to be connected to a location in this case ‘nursery’ but irrespective of the physical location of your daughter – physically in the nursery or in the room with you and your wife – she was being cared for, monitored, and having ongoing assessments by expert nursing personnel. Fortunately, most babies and it sounds like including your daughter, transition into their new life relatively seamlessly but sometimes they don’t do quite so well. That’s why they are watched. Every time someone came in and discussed feedings with you and looked at diapers those experts were assessing your daughter. They looked at her coloring, they noted the rate of her respirations, they listened to her heart rate. They took her temperature to assess for any signs of infection and to ensure that her body was able to maintain normal thermoregulation. They did multiple tests / screenings on her – checking her hearing, monitored for jaundice, did a cardiac screening to make sure that everything was functioning right after going from inside a uterus to the outside world. They took blood samples and sent them to a state lab to be able to pick up a multitude of potential life threatening diseases that if caught early can be treated effectively. Those expert nurses taught you how to care for your newborn daughter including showing you safe sleep practices to minimize the risks of SIDS. Your daughter was mainly cared for in your wife’s room because research supports keeping the family together is physiologically what is best for both mother and infant. Mr. Cortes, you didn’t pay for ‘babysitting’. You paid experts to care for your daughter for that $1402. As a maternity nurse of many, many years I can attest to the times that those ‘babysitters’ picked up on some vague clinical symptoms on a newborn and because of their expertise were able to save lives. I am so glad your daughter is doing well. I think you got a bargain.

    • Somehow you missed a key point here. These folks were charged over $1400 for an optional service they weren’t told had an additional charge. This happens a lot. It happens consistently to my brother, who has stage 4 cancer, and is constantly having to question and challenge charges, not by his doctor, not by the labs, not by specialist opinions, but by the hospital where he takes his treatments because otherwise he’d have to spend hours traveling to a big city hospital. Yes, it is the only hospital in his community, and the CEO makes a lot of money, an astonishing lot of money for a small hospital in a small town. 3000 miles away, I had a similar experience when I had surgery that did not go well because the surgeon ordered medication to which I was allergic– a fact that was not only in my charts, but was also conveyed to him verbally and in person before the surgery. I was charged for the care I needed as a result. That was not the only issue I experienced with that hospital, and almost all of them involved errors with record-keeping along with errors in procedure. The issue with hospital charges has yet to be resolved.

  • I love this article and I am going through the same challenge with Boston children hospital for a different reason. I am refusing to pay the bill as the hospitals charter says it should be providing a cost efficient quality service and yet they do all these tests and the provide you with the bill. My biggest concerns is that these bills are very major bills for non critical surgeries / tests / support which really impacts people’s financial stability which people are not aware of until they get the bill. If hospitals want to treat their patients like customer then they need to let patients know the costs involved before taking an action so that the patients is well informed.

  • I once asked the the staff at the opthalmologist’s office what the charge would be before my appointment. They said the doctor would decide that. Are you kidding me, they wouldn’t even tell me what it was going to cost!

  • Three things – you had nine months to research the charges you were going to incur at the time of your baby’s birth. You probably spent more time researching the cost of your cellphone.
    2. Your have insurance. If your insurance carrier had a contract with that hospital, then you paid the insurer’s negotiated rate, not the public charge.
    3. If you have a choice between a high or low deductible plan, and you chose a high deductible plan, you should have expected to pay up to the entire amount of the deductible when you obtained healthcare services.

    You may have issues with your employer because of their healthcare plan, or you may have issues with your insurer for negotiating lousy rates, but your complaint about the hospital is without merit.

    Community Hospital provide healthcare 24 hours a day, 7 days a week and 365 days a year. They are not quick marts or gas stations. Their labor, supplies and equipment cost a lot of money. Without a hospital in your community, people could die trying to get services elsewhere.

    And, by the way, most hospitals charge for Nursery by the day, not the hour!

  • The questions no one has asked:
    1. How many babies were in the Nursery at the same time?
    2. Was there a charge for each baby?
    3. What qualifications did the “babysitter” have?
    4. How many years’ experience did the “babysitter” have?
    5. Does a single mother without insurance, who claims she does not know who the father is, offered Nursery Services?
    6. Is the Nursery in a truly secure area?
    7. How much is the “babysitter” paid an hour? (Presuming the amount will be averaged for location.)
    8. And why are employees surprised and not prepared by their management to supply these answers?

  • Hospital charges have always been pretty outrageous in the 45 years I have (unfortunately) been using them.

    But more and more, instead of being run by physicians and other medical practitioners, they are run by MBAs whose only purpose is to increase profits. Just look at the salaries of the heads of hospitals!

  • I would not lose a moment’s sleep over such an outrageous bill. I would simply not pay it, not ever. It reminds me of those internet scams we hear about. If I am on the jury, I say “Would you like me to take your baby to the nursery” is an offer of a favor, a gift. If the scammer had said instead “Would you like to hire me to take your baby for $700 an hour,” that’s another matter. But the scammer didn’t say that.

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