Saskatchewan couple face $1M medical bill for US birth

[opendoor]

Originally Posted by polak

What would the situation be if the roles were flipped and these were americans in Canada?

They (or their insurance company) would owe a hell of a lot of money. Most emergency rooms post rates for patients that aren't covered by government insurance and they're pretty expensive. Not as crazy as US prices because they're generally standardized and mandated, but I'd guess the bill would still be in the hundreds of thousands of dollars.

[nfotiu]

Originally Posted by Table 5

My point is not that the way administer health care in the US is justified (because its not), it's that the core medical costs would still be relatively expensive here too if you think about what goes into treating a child for that long. We still have to pay our doctors, our nurses, support staff, buy medical equipment, buy medicine etc. Public health care doesn't mean free health care.

Medical systems are intrinsically expensive...which is why it's really stupid that anyone in the US expects a for-profit system to work or why so many of it's citizens think changing it is a bad thing.

My understanding from when I ran into a similar situation that did get covered is that the provincial health care will pay the bill up to the amount that the same procedure would have cost in Canada. The travel insurance Canadian's get is to cover the gap between what the provincial health care pays and what the American hospital is paying. If the costs were similar, than Saskatchewan should be paying a big chunk of it.

A crazy side note though is that hospitals charge individuals far more than they charge Insurance companies. So if insurance was covering it, the bill would look like something like $1,000,000 minus $600,0000 insurance discount, and actual amount paid by insurance would only be $400,000. Ridiculously, individuals are responsible for the full un-discounted amount. I can only think they assume the majority of individuals that just don't pay, so any sucker who does pay has to pay for them.

What happens if a Canadian just doesn't pay a big American bill? Lots of harassing calls and possibly (but not for sure?) a bad mark on their credit?

[Bagor]

The whole point of contention seems to be her health at time of travel.

“I had a bladder infection and I hemorrhaged a bit at four months,” she said. “My doctor saw no reason for me not to go.“We had no questionnaire [from Blue Cross].”
She said her doctor sent a letter to Blue Cross confirming that Huculak’s pregnancy was stable when she went on vacation, but the claim was still denied.

Take away lesson here appears to be that if in doubt get a clearance to travel letter from your doc. Hopefully it is in her notes that he cleared her.

[bizaro86]

If they're back in Canada now, how does the hospital plan to collect? Are they holding the baby as collateral?

How easy/hard would it be for the hospital to sue them in SK for the money? Could they just never go to the US again?

[Radio]

Maybe they can petition the Canadian government to pay the bill. If I remember correctly wasn't there a couple in a similar situation a few years back that had to be flown back to Canada and the government paid the US medical bills (which were quite substantial). However, the government didn't offer pay initially only after it became a public story and in the interest of Pr they agreed.

I'll see if I can dig that up somewhere...

[undercoverbrother]

Originally Posted by bizaro86

If they're back in Canada now, how does the hospital plan to collect? Are they holding the baby as collateral?

How easy/hard would it be for the hospital to sue them in SK for the money? Could they just never go to the US again?

errrr bra

Spoiler!

[Burninator]

This same thing happened to an old neighbour of mine. Gave very premature birth when she was visiting her husband who was working in the US. Had an absolutely massive hospital bill that wasn't covered by travel insurance. I believe insurance said the child wasn't covered because he didn't have insurance and you can't get insurance on a child that hasn't been born. A bunch of companies in Calgary helped a lot same with donations from people and the Alberta government ended up paying most of the bill including charting a jet with a nurse and incubator (or whatever they use) back to Calgary.

[CaptainCrunch]

Originally Posted by Bagor

The whole point of contention seems to be her health at time of travel.




Take away lesson here appears to be that if in doubt get a clearance to travel letter from your doc. Hopefully it is in her notes that he cleared her.

She'd better be able to produce it and her Doctor has to confirm it.

I would never travel to the US if there was any doubt of a health issue based on something pre-existing, its the easiest thing for an insurance company to use to deny.

The hospital will probably move to get a judgement against the family and them move for seizures or garnishment of wages.

To be pretty clear this isn't the fault of the hospital or the health care system this is a problem between the insurance company and the couple.

[scotty2hotty]

Originally Posted by bizaro86

If they're back in Canada now, how does the hospital plan to collect? Are they holding the baby as collateral?

How easy/hard would it be for the hospital to sue them in SK for the money? Could they just never go to the US again?

I'd like to know this as well. What happens if they just don't pay?

[Burninator]

Originally Posted by Radio

Maybe they can petition the Canadian government to pay the bill. If I remember correctly wasn't there a couple in a similar situation a few years back that had to be flown back to Canada and the government paid the US medical bills (which were quite substantial). However, the government didn't offer pay initially only after it became a public story and in the interest of Pr they agreed.

I'll see if I can dig that up somewhere...

I bet we are talking about the same story. I recall the government 'finding' an emergency fund for just such a scenario after the story got big in the media. I think it was around 15 years ago. I tried looking but couldn't find anything.

[Locke]

Originally Posted by Radio;5010440[B

]Maybe they can petition the Canadian government to pay the bill.[/B] If I remember correctly wasn't there a couple in a similar situation a few years back that had to be flown back to Canada and the government paid the US medical bills (which were quite substantial). However, the government didn't offer pay initially only after it became a public story and in the interest of Pr they agreed.

I'll see if I can dig that up somewhere...

You know, I dont know how I'd feel about that. I think its because I see the bill as patently absurd. No one should have to pay that.

What happens if the hospital cant collect and has to write it off of their receivables? I doubt the hospital is going to have to shut up shop.

Although it would set a very grim precedent.

[calgarygeologist]

What does Obamacare provide for insurance? The baby is an American citizen by birth and thus would qualify for whatever Obamacare or Medicaid is available.

[Locke]

Originally Posted by CaptainCrunch

She'd better be able to produce it and her Doctor has to confirm it.

I would never travel to the US if there was any doubt of a health issue based on something pre-existing, its the easiest thing for an insurance company to use to deny.

The hospital will probably move to get a judgement against the family and them move for seizures or garnishment of wages.

To be pretty clear this isn't the fault of the hospital or the health care system this is a problem between the insurance company and the couple.

I disagree with that. Insurance or no insurance it should not cost a million bucks.

I mean, if you want to get paid then charge a reasonable amount, but I can tell you with a fair degree of certainty that even though I've never met these people they likely dont have a million bucks lying around so they're going to go bankrupt and default on the payment.

Cut that number by three quarters and have an insurance company or government willing to chip in a bit and we're talking, otherwise they get nothing.

[Calgary14]

Apparently one lawyer is recommending they don't pay. The hospital would have to go across the border (into Canada) and likely sue to collect which he said he's yet to ever see. If they don't pay the bill would likely be written off if it was much smaller but given the size I can't see them getting off the hook that easily. This could drag on for a while and the scary part is that interest would be added to the amounts owing

[CaptainCrunch]

Originally Posted by Locke

You know, I dont know how I'd feel about that. I think its because I see the bill as patently absurd. No one should have to pay that.

What happens if the hospital cant collect and has to write it off of their receivables? I doubt the hospital is going to have to shut up shop.

Although it would set a very grim precedent.

That's the problem. We call the bills absurd and crazy,

But this was a 3 month premature baby and the mother had a lengthy hospital say as well. I read somewhere that keeping a premature baby alive is really expensive in terms of treatments.

We get shielded from medical costs up here because they're basically covered.

the health care system did its job down there, the baby survived and got healthy the mother got the proper treatment.

Its between the doctor and the insurance company right now with the family and the hospital potentially being the wronged parties.

The hospital will be allowed to file for a judgement up here, and if they get it go after the recovery of the fees, they don't care if they get it from the family or the insurance company.

The doctor has to be investigated, if he stated that she was ok to travel after having a hemmorage and a infection early in the pregnancy he could be on the hook as well.

The insurance company could be on the hooked based on the letter if it can be produced.

[scotty2hotty]

Originally Posted by Calgary14

Apparently one lawyer is recommending they don't pay. The hospital would have to go across the border (into Canada) and likely sue to collect which he said he's yet to ever see. If they don't pay the bill would likely be written off if it was much smaller but given the size I can't see them getting off the hook that easily. This could drag on for a while and the scary part is that interest would be added to the amounts owing

But what would even be the point in suing to collect? I highly doubt that this couple has the money but is simply refusing to pay.

Let's say, for arguments sake, that this couple has $100k in assets. Would the hospital be fine with just collecting on that and calling it a day?

[DuffMan]

Maybe they could get them to bill the baby and the baby could claim bankruptcy. It would be off his/her record by grade 2.

[CaptainCrunch]

Originally Posted by Locke

I disagree with that. Insurance or no insurance it should not cost a million bucks.

I mean, if you want to get paid then charge a reasonable amount, but I can tell you with a fair degree of certainty that even though I've never met these people they likely dont have a million bucks lying around so they're going to go bankrupt and default on the payment.

Cut that number by three quarters and have an insurance company or government willing to chip in a bit and we're talking, otherwise they get nothing.

this isn't a car repair bill Locke. The baby was born 3 month premature, and the treatment of premature babies is very complex and can be really expensive.

I don't know enough about the condition of the baby. But talking to my sister the doctor about the story she figures that the treatment and the specialist work and the lab work and anything else, its probably not that far out of the realm of possibilities.


We always get shocked by the costs of treatment up here, but that's because so much of it is covered and hidden in terms of costs from the end users.

we're not talking about a warming blanket, a family physician and a box of formula here.

[CaptainCrunch]

Originally Posted by scotty2hotty

But what would even be the point in suing to collect? I highly doubt that this couple has the money but is simply refusing to pay.

Let's say, for arguments sake, that this couple has $100k in assets. Would the hospital be fine with just collecting on that and calling it a day?

You never get anything in a collection but you try to get something reasonable.

I don't know how insurance works in the states, but I'm assuming that the hospital called Blue Cross when she arrived at the hospital and gave her policy number though.

Most hospital usually need that information before they start treating.

[Flash Walken]

Originally Posted by Table 5

My point is not that the way administer health care in the US is justified (because its not), it's that the core medical costs would still be relatively expensive here too if you think about what goes into treating a child for that long. We still have to pay our doctors, our nurses, support staff, buy medical equipment, buy medicine etc. Public health care doesn't mean free health care.

Medical systems are intrinsically expensive...which is why it's really stupid that anyone in the US expects a for-profit system to work or why so many of it's citizens think changing it is a bad thing.

Right, things cost money.

3 Weeks in neonatal could be a 1000% more expensive in one hospital vs. the one across the street and the services delivered could be worse.

Only in the United States is pregnancy generally billed item by item, a practice that has spiraled in the past decade, doctors say. No item is too small. Charges that 20 years ago were lumped together and covered under the general hospital fee are now broken out, leading to more bills and inflated costs. There are separate fees for the delivery room, the birthing tub and each night in a semiprivate hospital room, typically thousands of dollars. Even removing the placenta can be coded as a separate charge.

Each new test is a new source of revenue, from the hundreds of dollars billed for the simple blood typing required before each delivery to the $20 or so for the splash of gentian violet used as a disinfectant on the umbilical cord (Walgreens’ price per bottle: $2.59). Obstetricians, who used to do routine tests like ultrasounds in their office as part of their flat fee, now charge for the service or farm out such testing to radiologists, whose rates are far higher.

Add up the bills, and the total is startling. “We’ve created incentives that encourage more expensive care, rather than care that is good for the mother,” said Maureen Corry, the executive director of Childbirth Connection.

In almost all other developed countries, hospitals and doctors receive a flat fee for the care of an expectant mother, and while there are guidelines, women have a broad array of choices. “There are no bills, and a hospital doesn’t get paid for doing specific things,” said Charlotte Overgaard, an assistant professor of public health at Aalborg University in Denmark. “If a woman wants acupuncture, an epidural or birth in water, that’s what she’ll get.”

Despite its lavish spending, the United States has one of the highest rates of both infant and maternal death among industrialized nations, although the fact that poor and uninsured women and those whose insurance does not cover childbirth have trouble getting or paying for prenatal care contributes to those figures.

Some social factors drive up the expenses. Mothers are now older than ever before, and therefore more likely to require or request more expensive prenatal testing. And obstetricians face the highest malpractice risks among physicians and pay hundreds of thousands of dollars a year for insurance, fostering a “more is safer” attitude.

But less than 25 percent of America’s high payments for pregnancy typically go to obstetricians, and they often charge a flat fee for their nine months of care, no matter how many visits are needed, said Dr. Robert Palmer, the chairman of the committee for health economics and coding at the American College of Obstetricians and Gynecologists. That fee can range from a high of more than $8,000 for a vaginal delivery in Manhattan to under $4,000 in Denver, according to Fair Health, which collects health care data.