Saskatchewan couple face $1M medical bill for US birth

[Azure]

This is why health care should be a non-profit industry.

Our system isn't perfect either, but probably a lot more fixable than what the US has.

[ExiledFlamesFan]

For profit healthcare is a terrible idea. It wasn't that long that us Canadians were whining about our system and wanting our system to be more Americanized. This is what you get. Gouging.

People complain about such long waitlists for everything from CT scans to hip replacements. If you are waiting, you are waiting because it is not urgent. Any urgent procedure/scan will be done and done quickly.

Just for my own curiosity I'll do some quick math regarding this case and gouging:
-Mom's stay was $160,000!!!!!!. This number is insane itself. Unless Mom was in intensive care for 60 days, which she obviously wasn't. An intensive care bed is about $2000/day. A regular bed on a hospital ward is about $750/day. Let's say mom spent a day before her C section, then 5 days after (being generous) as an inpatient recovering. So mom costs $4 500
-The U.S. (I don't even know what that means, government?) picked up the cost for the C section delivery, which was $12,000. This is still high but at least reasonable.
-Baby in in NICU for 2 months. This is expensive. Let's say an average of $2500/day. The baby would be much more expensive during the first few weeks of the stay while being ventilated and requiring 1 to 1 care, but as time went out would be less and less expensive. Total for 60 days, $150 000
-Add in tests costs. Ultrasounds, CT, Xrays, bloodwork, whatever tests they could possibly do. We'll say the total cost is $10 000

All of my numbers are very generous. Total cost: $176 500. Yet the total medical bill was $900 000 according to mom. Wow

American health care: Dolla dolla bills y'all

[zyzz]

What idiots. I'm sure there will be some sort of charity drive that'll bail them out. Rules are rules, no sympathy here!

Edit: A friend of a friend was down in Palm Springs and had a heart attack with no insurance, ended up dying and his family is still paying for it 15 years later. Guy I worked with broke his leg and ended up paying something stupid like 15K. Don't see why this couple should get any special treatment.

[Azure]

Originally Posted by ExiledFlamesFan

For profit healthcare is a terrible idea. It wasn't that long that us Canadians were whining about our system and wanting our system to be more Americanized. This is what you get. Gouging.

People complain about such long waitlists for everything from CT scans to hip replacements. If you are waiting, you are waiting because it is not urgent. Any urgent procedure/scan will be done and done quickly.

No, you wait because there aren't enough doctors, equipment, resources, etc, etc in place to help you. Should someone have to wait 6 months for a MRI? People live with pain all the time too in our system because they can't get help. I know many people who have gone to the US for medical help because the wait was too long here in Canada. IMO, that is a fixable problem. We are delivering health care the right way, but it needs to be more efficient, obviously. The wait times certainly isn't something I'd just sit back and accept. There are always ways to improve everything.

The problem is, everytime someone wants to change something about our health care system, the whole 'we will become like the US' crap gets thrown around.

[ExiledFlamesFan]

Originally Posted by Azure

No, you wait because there aren't enough doctors, equipment, resources, etc, etc in place to help you. Should someone have to wait 6 months for a MRI? People live with pain all the time too in our system because they can't get help. I know many people who have gone to the US for medical help because the wait was too long here in Canada. IMO, that is a fixable problem. We are delivering health care the right way, but it needs to be more efficient, obviously. The wait times certainly isn't something I'd just sit back and accept. There are always ways to improve everything.

The problem is, everytime someone wants to change something about our health care system, the whole 'we will become like the US' crap gets thrown around.

Hence the term "urgent". If you have suspected lung cancer and need a CT scan you will be scanned very quickly. If you have some back chronic back pain it might take months to get a CT scan. I don't really see a problem with this, we give priority to people who need it. If you are impatient and need a scan right away, go ahead and pay for it out of pocket. We leave it up to the experienced and educated medical professionals to determine the urgency of your problem.

Your idea of getting everyone in quickly would make our healthcare unaffordable. We have to find a balance between cost and wait time. It will never be perfect. The more efficient the better of course.

What is your solution?

[Regular_John]

Originally Posted by ExiledFlamesFan

For profit healthcare is a terrible idea. It wasn't that long that us Canadians were whining about our system and wanting our system to be more Americanized. This is what you get. Gouging.

People complain about such long waitlists for everything from CT scans to hip replacements. If you are waiting, you are waiting because it is not urgent. Any urgent procedure/scan will be done and done quickly.

Just for my own curiosity I'll do some quick math regarding this case and gouging:
-Mom's stay was $160,000!!!!!!. This number is insane itself. Unless Mom was in intensive care for 60 days, which she obviously wasn't. An intensive care bed is about $2000/day. A regular bed on a hospital ward is about $750/day. Let's say mom spent a day before her C section, then 5 days after (being generous) as an inpatient recovering. So mom costs $4 500
-The U.S. (I don't even know what that means, government?) picked up the cost for the C section delivery, which was $12,000. This is still high but at least reasonable.
-Baby in in NICU for 2 months. This is expensive. Let's say an average of $2500/day. The baby would be much more expensive during the first few weeks of the stay while being ventilated and requiring 1 to 1 care, but as time went out would be less and less expensive. Total for 60 days, $150 000
-Add in tests costs. Ultrasounds, CT, Xrays, bloodwork, whatever tests they could possibly do. We'll say the total cost is $10 000

All of my numbers are very generous. Total cost: $176 500. Yet the total medical bill was $900 000 according to mom. Wow

American health care: Dolla dolla bills y'all

Yeah I had a coworker a few years ago who's daughter was born near 4 months pre-mature and spend the first 5-6 months of her life in the hospital as a result. Multiple procedures, round the clock treatment, etc. My coworker said the total "bill" would have been in the neighbourhood of $400k according to one of his doctors.

So yeah, $950k is clearly in crazy town.

[Azure]

Originally Posted by ExiledFlamesFan

Hence the term "urgent". If you have suspected lung cancer and need a CT scan you will be scanned very quickly. If you have some back chronic back pain it might take months to get a CT scan. I don't really see a problem with this, we give priority to people who need it. If you are impatient and need a scan right away, go ahead and pay for it out of pocket. We leave it up to the experienced and educated medical professionals to determine the urgency of your problem.

Your idea of getting everyone in quickly would make our healthcare unaffordable. We have to find a balance between cost and wait time. It will never be perfect. The more efficient the better of course.

What is your solution?

You don't see the problem with people living in chronic pain? You do realize of course the cost of that is expensive, right?

The impact?

Three quarters of the people waiting for care at Canadian pain clinics say it interferes with their normal work life. More than half suffer from severe levels of depression. And almost 35 per cent report that they've considered suicide.

According to the Canadian Pain Society, chronic pain is an expensive problem, not only to the patient but also to society as a whole. It costs billions of dollars a year in health costs, lost productivity, not to mention the social cost to lives that are derailed by addiction or depression.

http://www.cbc.ca/news/health/chroni...ions-1.2681223

If you don't see a problem with that you've bought into the whole grandstanding about how great our healthcare system is compared to the mess the US has far too much.

People should be able to get the care they need when they seek it regardless of their problem. If there is a problem making that happen, then our system needs to be changed.

Chronic pain is only part of the problem. 1 in 5 people live with some kind of mental problem, and most of those people are not getting the help they need either. The cost to our country? Billions as well.

My solution? There is no perfect solution, but there are always improvements to make. Start looking at the administrative cost of delivering healthy care. This is a big problem with AHS for one. Focus more on preventive care to catch problems before they arise. There are huge advances being made in the US for blood tests and how fast and efficiently they can be carried out. Walgreens is on the verge of implementing an extremely fast, cheap and efficient method to improve the blood test.

http://www.engadget.com/2014/11/18/w...s-blood-tests/

This is huge for preventive care. At some point having to wait 4 hours for a simple blood test is going to discourage a lot of people from having it done.

You'd think a method like that would get huge approval from doctors all over the world, but I'd imagine it will take 5 years before Canada does anything of the like.

There are also methods of allowing private diagnosis clinics in Canada. Apply a tax where the money goes towards the health care system if someone wants to join the line, and restrict it to non-profits.

Doing nothing is the problem.

There are lots of ideas.

http://business.financialpost.com/20...thcare-system/

For example, when someone comes in for surgery the surgeon and hospital are paid from one source that is separate from the one that pays for home care when the patient is discharged. The GP looking after the patient post-surgery is also paid separately, creating a very territorial system.

The main reason for this is that the system we have today was designed to meet the needs of people decades ago. In the early days of the Canada Health Act, much of what was covered was hospital-based care. But Canada has moved away from hospital-based care to other settings such as surgical centres and specialized clinics that can do a lot of what used to be done in hospitals.

There was time in the 1980s when Canada’s healthcare system fared well against international measures. That however was when society needed to respond to acute conditions, says Stephen Samis, vice president of programs for the Canadian Foundation for Healthcare Improvement (CFHI) in Ottawa. “We’ve not built a well-integrated system that matches the health status and complex conditions of Canadians today. We now have a very challenging model in terms of management and maximizing productivity.”

[ExiledFlamesFan]

Originally Posted by Azure

You don't see the problem with people living in chronic pain? You do realize of course the cost of that is expensive, right?



http://www.cbc.ca/news/health/chroni...ions-1.2681223

If you don't see a problem with that you've bought into the whole grandstanding about how great our healthcare system is compared to the mess the US has far too much.

People should be able to get the care they need when they seek it regardless of their problem. If there is a problem making that happen, then our system needs to be changed.

Chronic pain is only part of the problem. 1 in 5 people live with some kind of mental problem, and most of those people are not getting the help they need either. The cost to our country? Billions as well.

My solution? There is no perfect solution, but there are always improvements to make. Start looking at the administrative cost of delivering healthy care. This is a big problem with AHS for one. Focus more on preventive care to catch problems before they arise. There are huge advances being made in the US for blood tests and how fast and efficiently they can be carried out. Walgreens is on the verge of implementing an extremely fast, cheap and efficient method to improve the blood test.

http://www.engadget.com/2014/11/18/w...s-blood-tests/

This is huge for preventive care. At some point having to wait 4 hours for a simple blood test is going to discourage a lot of people from having it done.

You'd think a method like that would get huge approval from doctors all over the world, but I'd imagine it will take 5 years before Canada does anything of the like.

There are also methods of allowing private diagnosis clinics in Canada. Apply a tax where the money goes towards the health care system if someone wants to join the line, and restrict it to non-profits.

Doing nothing is the problem.

There are lots of ideas.

http://business.financialpost.com/20...thcare-system/

Do you know what chronic means? It's something that you live with. ####ty, I know. Maybe this person with chronic back pain would be a candidate for surgery. Again, we leave that up to the educated experienced medical professionals. I am certainly no back expert but I imagine many cases of chronic back pain are treated with painkillers. You live with chronic diseases like COPD and diabetes. That's why the are chronic.

Saving money on labwork? Are you aware of how small the costs are of bloodwork are compared to actual treatment and therapy in our healthcare system? You are going to have to find much larger and more expensive departments to cut if you are looking to buy 10 more MRIs for the province. But it does sound interesting, I'm sure it would be a way to save some money.

I have never had to wait 4 HOURS!!! for a bloodtest, not sure where you are going to get your bloodwork done.

Talk to anyone that has needed the Canadian healthcare system for a life threatening condition, and chances are they are very happy to be Canadian.

Complaining about Canadian healthcare has become a national past time. When you compare our system to the American system ours is much cheaper, much more efficient, and most importantly, so much more fair. Certainly there is always room for improvement, don't get me wrong. But this million dollar baby shows just how gouging the American system is.
http://www.forbes.com/sites/danmunro...her-countries/

Just as Starbucks SBUX +0.32% spends more on healthcare benefits than coffee beans

[ricosuave]

Originally Posted by zyzz

What idiots. I'm sure there will be some sort of charity drive that'll bail them out.

Up to 3 hun at the time of this posting!

http://www.gofundme.com/hipmnw

[Flamenspiel]

Originally Posted by ExiledFlamesFan

Do you know what chronic means? It's something that you live with. ####ty, I know. Maybe this person with chronic back pain would be a candidate for surgery. Again, we leave that up to the educated experienced medical professionals. I am certainly no back expert but I imagine many cases of chronic back pain are treated with painkillers. You live with chronic diseases like COPD and diabetes. That's why the are chronic.

Talk to anyone that has needed the Canadian healthcare system for a life threatening condition, and chances are they are very happy to be Canadian.

Complaining about Canadian healthcare has become a national past time. When you compare our system to the American system ours is much cheaper, much more efficient, and most importantly, so much more fair. Certainly there is always room for improvement, don't get me wrong. But this million dollar baby shows just how gouging the American system is.
http://www.forbes.com/sites/danmunro...her-countries/

Well there are a lot of things wrong with this response, have you ever lived with pain? painkilling drugs are not a cure, they do not even deal with the problem. Its just to tide you over until the problem is fixed.

I don't think you read that report, Canada is 10, US is 11th. I don;t think thats something to brag about. The US ranked highly in timeliness and effectiveness. Canada ranked low in all but "cost". So according to the report we have a mediocre system but its cheap. I think most people would agree with that.

[ExiledFlamesFan]

Originally Posted by Flamenspiel

Well there are a lot of things wrong with this response, have you ever lived with pain? painkilling drugs are not a cure, they do not even deal with the problem. Its just to tide you over until the problem is fixed.

I don't think you read that report, Canada is 10, US is 11th. I don;t think thats something to brag about. The US ranked highly in timeliness and effectiveness. Canada ranked low in all but "cost". So according to the report we have a mediocre system but its cheap. I think most people would agree with that.

I am very aware of chronic disease. Half my patients have COPD. There is no cure. I am sure chronic back pain is similar.

The issue at hand in this thread is obviously cost. Specifically a person being gouged over half a million dollars. Hopefully you see the problem with this.

[Bagor]

Originally Posted by j_j

I'm no doctor, but how hard is it to draw a line between vaginal bleeding during the pregnancy and early delivery? Probably not all that hard.

The lady mentioned the bleeding as being connected to a bladder infection. Could be as simple as a trace of blood in her urine.

Does that equate to a high risk for early delivery? I don't know. I wouldn't have thought so.

But that appears to be the reason for the denial (pre existing condition provision).

How does that work then. Say you have a history of angina and have a heart attack. You're out of luck? You're on blood thinners and you stroke ... same?

If that's the case why isn't there screening questionnaires to enable people to buy a product that covers them?

[Flamenspiel]

^^Yes i get it with COPD(i had to look it up). But chronic back pain, knee pain, tennis elbow, and other orthopedic pain can often be solved with surgery. It can be 5-10 years between a diagnoses and repair in these areas. Years can be wasted on painkillers, physio, and/or chiropractors, the delays are built in to the Canadian system to steer you into expensive treatments only after you do your time. I have spoken candidly with doctors about this, they joke about how you've made it into the club(after a few years) and now we are really going to help you.

It is a fact that since Obamacare was adopted less and less people fall through the cracks in the US. Its is not cheap(600-800$)a month if your middle class but once you are sick you can get an MRI in a few days instead of years. This is an isolated case of an uninsured Canadian couple, its no longer a typical case. The fact is that its more a lesson on out of country insurance scams then the US system.

The bottom line is, they ranked 11 systems, we ended up 10th, the US in 11th. Its like celebrating the fact that you finished 29th in the NHL instead of 30th.

To certain extent I guess we get what we pay for as our taxes are far lower then the other countries on the list.

[ExiledFlamesFan]

Originally Posted by Flamenspiel

^^Yes i get it with COPD(i had to look it up). But chronic back pain, knee pain, tennis elbow, and other orthopedic pain can often be solved with surgery. It can be 5-10 years between a diagnoses and repair in these areas. Years can be wasted on painkillers, physio, and/or chiropractors, the delays are built in to the Canadian system to steer you into expensive treatments only after you do your time.

It is a fact that since Obamacare was adopted less and less people fall through the cracks in the US. Its is not cheap(600-800$)a month if your middle class but once you are sick you can get an MRI in a few days instead of years. This is an isolated case of an uninsured Canadian couple, its no longer a typical case. The fact is that its more a lesson on out of country insurance scams then the US system.

I have never heard of somebody waiting "years" for an MRI. In Alberta, 90% of non urgent patient requiring an MRI have had one in 35 weeks.

90% of urgent patients requiring an MRI have had one in 3 weeks.

http://waittimes.alberta.ca/WaitTime...e#WaitTimeInfo

This type of wait time exaggeration is common, you're not the first one.

The biggest thing you can do as a patient is have a great family physician who will refer you to the right places and order pertinent tests. If there's one thing we can do better, it's to make sure all Albertan's have access to a family doc.

Originally Posted by Flamenspiel

To certain extent I guess we get what we pay for as our taxes are far lower then the other countries on the list.

Exactly. And that was my original point. If you want to get your non urgent MRI within a week, or get your non urgent hip replacement within a week, get ready for huge tax increases.

[Traditional_Ale]

Originally Posted by zyzz

What idiots. I'm sure there will be some sort of charity drive that'll bail them out. Rules are rules, no sympathy here!

Edit: A friend of a friend was down in Palm Springs and had a heart attack with no insurance, ended up dying and his family is still paying for it 15 years later. Guy I worked with broke his leg and ended up paying something stupid like 15K. Don't see why this couple should get any special treatment.

And you don't see something seriously unethical about sending a medical bill to a dead man's family? If he had lived, then sure, but if I mess up a job I don't get paid for it. You must be American.

[Robotic]

Not sure if this has already been explained yet, as I haven't read the whole thread. There are PPO networks in the US that can negotiate the price of medical bills down to significantly lower. Most of the time it will be brought down to 1/3 or better than the original amount. In this case a $900k bill could be brought down to $300K. This is an agreement with the Insurance provider and a network of other hospitals/facilities to encourage patients to visit one of their hospitals. Most major hospitals are within one network or another.

The pre-existing condition would not be eligible whether it was an emergency or not. This would be a standard exclusion, and would only be waived in the event an increase in premium was made.

You're required to read and understand the contract. I'd threaten to go to court, and then Blue Cross would eventually loose as the courts favour individual families over insurance companies.

[JiriHrdina]

Originally Posted by Bagor

The lady mentioned the bleeding as being connected to a bladder infection. Could be as simple as a trace of blood in her urine.

Does that equate to a high risk for early delivery? I don't know. I wouldn't have thought so.

But that appears to be the reason for the denial (pre existing condition provision).

How does that work then. Say you have a history of angina and have a heart attack. You're out of luck? You're on blood thinners and you stroke ... same?

If that's the case why isn't there screening questionnaires to enable people to buy a product that covers them?

Pre-existing conditions is a big thing. My father had bypass surgery a few years ago and now that he's healthy again wants to travel. He pays crazy coin for travel insurance and also routinely ensures that based on his condition - he is still covered. I know he's had to answer long questionnaires and get documentation from his doctor - and do so regularly to make sure everything is good and he has his coverage.

So part of this is on the individual.

But $1M - what's the play here? The hospital must know they aren't going to collect on it?

Something smell rotten here for sure. I think the patients dropped the ball in terms of understanding their coverage - but that doesn't mean their financial life should be utterly ruined.

I'm surprised though how many people travel that late in a pregnancy.

[Flamenspiel]

Originally Posted by ExiledFlamesFan

I have never heard of somebody waiting "years" for an MRI. In Alberta, 90% of non urgent patient requiring an MRI have had one in 35 weeks.

90% of urgent patients requiring an MRI have had one in 3 weeks.

http://waittimes.alberta.ca/WaitTime...e#WaitTimeInfo

OK, but a GP will not normally order an MRI in a specialized area. So using your link(thanks) it takes 35 weeks to get serviced by a specialist, plus 35 weeks to get an MRI. We are now up to almost a year and a half, that's quite a awhile for a test.

It sounds like the answer to all this is simply to go into an emergency clinic and that can skip the wait for a specialist. Now of course, its not an emergency, so......

I think we should agree that this is mediocre. Using your tools again, i checked out the wait times in London, England for full on knee surgery. Not only can you get an MRI, they do the full surgery in 18 weeks.

Lets just just agree its mediocre and not use terms like excellent, efficient, best in the world or anything like that. Cheap but mediocre.

[Bagor]

Originally Posted by JiriHrdina

Pre-existing conditions is a big thing. My father had bypass surgery a few years ago and now that he's healthy again wants to travel. He pays crazy coin for travel insurance and also routinely ensures that based on his condition - he is still covered. I know he's had to answer long questionnaires and get documentation from his doctor - and do so regularly to make sure everything is good and he has his coverage.

So part of this is on the individual.

Agreed with that and that they dropped the ball here. But my gut tells me that this couple tried their best to obtain what they thought was full coverage by meeting with their doctor and Blue Cross before traveling. I'm sure they mentioned that they were pregnant to Blue Cross.

I wouldn't have thought in a million years that something like a bladder infection would void your insurance?

[Clever_Iggy]

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?

A million bucks is worth the expense of chasing it to Canada. The couple isn't judgment proof, but there's a threshold where it's just not worth it for the hospital. They may try to settle with the couple for pennies on the dollar, but if the couple tells them to pound sand, the economics of chasing it only to force the couple into bankruptcy and collecting little to nothing probably makes the hospital walk away.