Saskatchewan couple face $1M medical bill for US birth

[ExiledFlamesFan]

Originally Posted by Flamenspiel

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.

I don't mean to be a dick but I don't think you know what you're talking about. Family physicians can an order MRIs for lower back pain. And apparently they are ordering too many and half of the lower back MRIs ordered are "inappropriate or of questionable value".

He noted that back pain is extremely common. “Almost all of us have back pain at some point. And generally, it is agreed in the medical literature and by the experts, imaging will not help in most cases,” he said.

“Most of the time, the treatment is the same – proper exercise and control of your weight,” he said. “Imaging helps only if we have something that might be surgical, like a true disc protrusion that is compressing a nerve route and it may benefit for patients to have that disc protrusion taken out.”

http://m.theglobeandmail.com/life/he...service=mobile
Your year and a half claim is another exaggeration.

[Bagor]

Originally Posted by Flamenspiel

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.

Not a hope in hell you get non-emergency knee surgery in the UK through their National Health System in 18 weeks. And I mean referral from Family Doctor to Specialist for Assessment then the actual surgery.

UK has a two tier system. Private and Public which I wish Canada would follow. I don't know where you are getting your data from but I am guessing the extremely short time it takes to get knee surgery done through the private route is skewing the NHS wait time.

[Rathji]

Originally Posted by Table 5

The thing is that actual medical care is really expensive everywhere. Keep a child in a neonatal unit for 2 months in Canada, and I doubt those costs would be that different. Doctors, nurses, medical equipment, administration, specialized medicine aren't magically a fraction of the price here.

The big difference is mostly just who pays for it.

The cost to the hospital is likely extremely similar. You gotta pay doctors and use fancy equipment, regardless of which side of the border you are on.

The difference in Canada is that the patient, through their taxes which funds the hospital's capital costs, salary, etc, pays a much smaller degree of markup on those services.

[wooohooo]

My girlfriend's parent was travelling in Hawaii, got real sick and found out she had an infection. Was in the hospital for a few weeks, still wasn't getting better so they did a full body mri, ct and xray and found out she had a lesion on her spinal cord. She was in Maui at the time and due to her condition was not stable enough to be flown to Honolulu so they had to fly a team of orthopedic surgeon's from honolulu over. After that she was better but her condition didn't improve and they missed another lesion causing them to operate again. But prices for insurance was getting out of control so they flew a private plane with a nurse back to Canada. They live in Fort Mac but I guess they had to fly them there... where they right away had to helivac her back to Edmonton where she underwent more tests and surguries to fuse her spinal cord together.

All that was close to a million dollars or so but lucky it was all covered by insurance.

[stampsx2]

If the contract hadn't expired would blue cross have paid or would they have found another loophole once they saw the bill?

I find it suspicious that insurance companies don't have a questionaire. They don't ask if you smoke, are overweight or had past health issues. As far as i'm concerned they should ask for your medical history before they approve you, but they don't. Everyone's approved all the time. I guess that's what's good for business.

[Dan02]

I just got travel coverage for a short trip to mexico, and not a single question was asked about anything.

[Calgary14]

Originally Posted by Dan02

I just got travel coverage for a short trip to mexico, and not a single question was asked about anything.

I don't think they do any research until you file a claim. Then when you file a claim they will look into your past medical history and try to determine if you had a pre-existing condition (which would mean the claim would be void)

[ken0042]

Originally Posted by ExiledFlamesFan

-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

Even though the costs are astronomical, that doesn't mean you can substitute your own made up numbers for the real ones.

She had the emergency, was treated for 6 weeks to make sure the baby would survive a premature birth. Then after giving birth the baby was in the neo-natal care for several more weeks. I obviously do not have anywhere near enough medical knowledge to understand what treatments would have been needed outside of just a hospital bed.

My bottom line is that Blue Cross should be covering this claim. That's why we get insurance, because we know the cost of going to a hospital in the States is very expensive.

[Robotic]

Its standard procedure for when someones admitted to a hospital, the administration gets in contact with the patients insurance to verify coverage and get a letter of guarantee of payment. The mother would have known since day 1 of admittance into the hospital that she didn't have coverage, well before any major bills were incurred. Yeah its not easy when knowing that the insurance company doesn't cover you, and you can't just leave to go on a plane back home where treatment is free.

I've seen cases of pre-matures, where the babies immunity was compromised so daily intravenous immune boosters were given and that would cost $15,000 a day if my memory serves me correctly. Again, this would have been repriced to a much lower number if the hospital was part of a PPO network.

[redforever]

Originally Posted by Bagor

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?

I don't think it is the bladder infection so much as it is the hemorrhaging that was a result of the infection. Any hemorrhaging in a pregnancy should be treated very seriously, no matter when it occurred or why it occurred.

I really question the doctor for approving air travel for this woman when she had prior hemorrhaging in her pregnancy...and really, part of the blame has to be with the couple here as well.

[Resolute 14]

Originally Posted by JiriHrdina

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

US Hospital: "You're Canadian?"
"Yes"
"You have travel insurance?"
"Yes"
"Cha-ching!"

I'm sure they never expected to collect $1 million, but charging such a stupid figure probably makes it easier to collect, say, $250k from the insurance company, which would still probably be quite profitable. Assuming the insurance company pays, of course.

[ExiledFlamesFan]

Originally Posted by ken0042

Even though the costs are astronomical, that doesn't mean you can substitute your own made up numbers for the real ones.

These numbers are not "made up". Feel free to refute them.

This is a case of extreme gouging.

Originally Posted by Resolute 14

US Hospital: "You're Canadian?"
"Yes"
"You have travel insurance?"
"Yes"
"Cha-ching!"

I'm sure they never expected to collect $1 million, but charging such a stupid figure probably makes it easier to collect, say, $250k from the insurance company, which would still probably be quite profitable. Assuming the insurance company pays, of course.

Exactly. This hospital is a business.

[Bagor]

Originally Posted by redforever

I don't think it is the bladder infection so much as it is the hemorrhaging that was a result of the infection. Any hemorrhaging in a pregnancy should be treated very seriously, no matter when it occurred or why it occurred.

I really question the doctor for approving air travel for this woman when she had prior hemorrhaging in her pregnancy...and really, part of the blame has to be with the couple here as well.

My bad. Misread the article as the bladder infection and hemorrhaging as being related and the same event.

The haemorrhaging I was referring to could have been simple blood in her urine as a result of the infection as opposed to separate vaginal bleeding directly related to the pregnancy.

[BigNumbers]

Originally Posted by Bagor

My bad. Misread the article as the bladder infection and hemorrhaging as being related and the same event.

The haemorrhaging I was referring to could have been simple blood in her urine as a result of the infection as opposed to separate vaginal bleeding directly related to the pregnancy.

[JiriHrdina]

Originally Posted by Dan02

I just got travel coverage for a short trip to mexico, and not a single question was asked about anything.

If you had a pre existing condition and did not reveal it: you would still run into problems

[Resolute 14]

Originally Posted by ExiledFlamesFan

Exactly. This hospital is a business.

That is the truly scary part of American medicare, I think. Our system has its own flaws, but at least our hospitals don't have to run PAID ADVERTISING to convince people to go there.

[Bagor]

Originally Posted by BigNumbers

I have no idea what that is supposed to represent or what you are trying to say. Can you elaborate?

[BigNumbers]

Originally Posted by Bagor

I have no idea what that is supposed to represent or what you are trying to say. Can you elaborate?

My own sense of immaturity at the discussion of lady parts, mostly.

[ExiledFlamesFan]

Originally Posted by Resolute 14

That is the truly scary part of American medicare, I think. Our system has its own flaws, but at least our hospitals don't have to run PAID ADVERTISING to convince people to go there.

These for profit hospitals have to answer to their shareholders first and foremost. Talk about a conflict of interest.

I'd also be interested to see how these for profit hospitals incentivize management. I'm sure there are healthy bonuses for making the hospital more $$$.

[Azure]

Originally Posted by Flamenspiel

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.

And there is course a constant drain of resources on emergency rooms simply because people go there instead of going to see their GP.

One of the biggest problems with our system right there.