I agree with much of what Gail has said regarding giving out
     pumps when there is not readily available help.  Perhaps
     sending home a pump if there must also be a formula sample
     pack going home with the mom makes some sense .

     However, I do feel compelled to contradict one of her
     statements.  When she says "The pump is covered if given while
     in the hospital", that isn't always truly the case.

     Most insurance companies (at least around here-Milwaukee WI)
     pay a fixed amount per case regardless of what the actual cost
     may be.  (e.g., $XXX for every vaginal delivery, even if there
     are complications and $YYY for every appendectomy, etc.)
     Therefore, what is "covered" actually comes out of the
     hospital's pocket.  Rarely does the amount paid by third party
     payers actually cover the cost (unless it is a very simple
     case where everything goes the smoothest possible).  The
     difference has to be made up for in other ways, including
     charging more for those who self pay or whose insurance dies
     cover full cost.  When LC's are still trying to prove their
     worth to an institution, we are put in the position of using
     supplies, etc. very judiciously so we keep the costs of our
     service low.  This includes not giving out something "just in
     case".

     It can put us between the proverbial "rock and a hard place"
     at times, but it is the current reality.

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