No laughing matter

In one of their ongoing highlights of ridiculous American hospital charges, NPR has the story of a woman (a midwife, no less) who had a pretty normal birth, and got a charge on her hospital bill for nearly $5,000 for having used nitrous oxide (laughing gas) for pain relief during the birth.

All very ridiculous (and the charge was revised down, when challenged, to around $500), but I was more interested in the fact that the gas is only coming into common use in birthing in the US recently.

My wife used it when (trying to) give birth to our son, now 19 years ago.  It seemed simple, safe and helpful.  But here's the story from the US:

Part of that problem comes down to the recent resurgence of the practice in the United States. In 2011, two hospitals in the U.S. offered nitrous oxide for childbirth. Now an estimated 1,000 hospitals and 300 birthing centers provide it, said Michelle Collins, a professor and director of nurse midwifery at Vanderbilt University School of Nursing.

The use of nitrous oxide has long been common during childbirth in the United Kingdom and Canada, in part because of its low cost. Many people in the U.S. have learned about the practice while watching the popular British period drama Call the Midwife, set in the 1950s. Epidural anesthesia largely displaced nitrous oxide in the U.S. in the 1970s.

Hmm.   Moved from a cheap, self administered, form of pain reduction to a highly medicalised one that removes all pain (if done properly) but also carries (I think) a very small risk of serious complication?

Is there something culture specific about the degree to which Americans seem to want to go to avoid even the hint of pain?   I mean, why hasn't the prescribed opioid problem been replicated in other countries?   Is it innate, or a result of what strong capitalism in medical practice pushes people to expect in their (the doctors') own self interest?   I mean, even the way medicines are advertised there just seems so odd to Australians.   (Mind you, I recently heard a breast enlargement ad here on FM radio recently - if I were able to ban that I would.)

I may have mentioned before, but I suspect Japan might be at the other extreme of expectation of tolerance of discomfort (or used to be, at least) as I was told by a specialist there some years ago that he did gastro-endoscopy, and without any form of anaesthesia at all.   But then again, I think Japanese women get to stay in hospital for days after birth.  Here, I just heard of a young woman who had a two hour labour, gave birth at 2am and was discharged at 9am (!)  (But there were midwife visits at home daily for the next week or so.)

Anyway, I still think Americans are a bit odd with the pain issue.