# Canadian Woman hit with huge medical bill. **URL:** \ **Category:** Factual Questions\ **Created:** [November 18, 2014, 8:20pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995 "2014-11-18T20:20:04Z")\ **Posts on this page:** 14\ **Page:** 3
**Author:** ![Dewey\_Finn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dewey_finn/32/4222_2.png) [@Dewey\_Finn](https://boards.straightdope.com/u/Dewey_Finn)\ **Post date:** [November 19, 2014, 9:04pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/41 "2014-11-19T21:04:46Z")
I was referring to medical travel insurance. ---
**Author:** ![MLS](https://avatars.discourse-cdn.com/v4/letter/m/919ad9/32.png) [@MLS](https://boards.straightdope.com/u/MLS)\ **Post date:** [November 19, 2014, 9:08pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/42 "2014-11-19T21:08:31Z")
> [@Dewey\_Finn](#): > > IANAL but I think the hospital would be liable. If a baby is brought in by an ambulance (without the parents present) or is brought in by a stranger, the hospital will treat the urgent need without needing those documents signed. So if the parents are there and are attempting to negotiate the terms of the documents, I’d expect the hospital to treat the urgent condition without waiting for the signatures. I went to the ER twice about a year ago, once for a serious injury and once for a nosebleed that wouldn’t quit. Now, these both needed attention lest I bleed to death, but I was not in imminent danger of doing so. In both cases the medical personnel started treatment on me immediately and before any issue of payment came up. ---
**Author:** ![Frylock](https://avatars.discourse-cdn.com/v4/letter/f/ce7236/32.png) [@Frylock](https://boards.straightdope.com/u/Frylock)\ **Post date:** [November 19, 2014, 9:18pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/43 "2014-11-19T21:18:46Z")
> [@The\_Joker\_and\_the\_Thief](#): > > Except there’s one exception to that rule, and that’s urgent medical care. In general, a court will create a [quasi-contract](http://en.wikipedia.org/wiki/Quasi-contract) between the parties involved. There’s plenty of caselaw in that area. Does any of the caselaw involve one party explicitly refusing the service? Does an enforceable quasi-contract still form even then? ---
**Author:** ![robert\_columbia](https://avatars.discourse-cdn.com/v4/letter/r/e79b87/32.png) [@robert\_columbia](https://boards.straightdope.com/u/robert_columbia)\ **Post date:** [November 19, 2014, 9:27pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/44 "2014-11-19T21:27:07Z")
> [@Frylock](#): > > Does any of the caselaw involve one party explicitly refusing the service? Does an enforceable quasi-contract still form even then? I would WAG that if a quasi-contract did exist, it would only cover a “reasonable” medical cost and “reasonable” terms and conditions of service. So no outrageous arbitration clauses, liability waivers, and whatnot. So maybe the court rules that that the services rendered to the patient were really worth approximately $70,000, not the $900,000 that the doctor billed. The patient never agreed otherwise (remember?). So in the absence of an explicit contract, the patient is obligated to pay a reasonable cost for the services, not the obscene rack rate. ---
**Author:** ![Canadjun](https://avatars.discourse-cdn.com/v4/letter/c/76d3ee/32.png) [@Canadjun](https://boards.straightdope.com/u/Canadjun)\ **Post date:** [November 19, 2014, 9:28pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/45 "2014-11-19T21:28:04Z")
> [@Omar\_Little](#): > > What am I missing? I thought travel insurance covered the cost of your missed trip if you have a medical emergency and you are not able to go on said trip. Sounds like the OP is talking about the cost of the pregnancy and hospital stay while they were on the vacation. That is not something that is normally covered by travel insurance. Given the insane prices you guys charge for medical care, travel insurance that Canadians (and I assume other country’s citizens) buy is supposed to include medical emergencies that arise **during** a visit to the US. Unfortunately, the insurance companies can be extremely strict about denying coverage if they have any suspicion of pre-existing conditions as a cause for the emergency. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [November 19, 2014, 9:40pm UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/46 "2014-11-19T21:40:46Z")
Which is why anytime I’ve heard of a Canadian needing medical care in the States, one of the first impulses is to get them home as soon as possible. The medical insurance normally covers travel costs home, because it’s in the insurance company’s best interest to pay the travel cost and get them back to Canada as quickly as possible. Sounds like that wasn’t medically possible in this case. ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [November 20, 2014, 12:15am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/47 "2014-11-20T00:15:48Z")
Ontario air ambulances have been known to pick up injured Canadian skiers from Minnesota, so as to avoid the American health care system entirely. ---
**Author:** ![Frylock](https://avatars.discourse-cdn.com/v4/letter/f/ce7236/32.png) [@Frylock](https://boards.straightdope.com/u/Frylock)\ **Post date:** [November 20, 2014, 12:22am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/48 "2014-11-20T00:22:18Z")
> [@robert\_columbia](#): > > I would WAG that if a quasi-contract did exist, it would only cover a “reasonable” medical cost and “reasonable” terms and conditions of service. So no outrageous arbitration clauses, liability waivers, and whatnot. So maybe the court rules that that the services rendered to the patient were really worth approximately $70,000, not the $900,000 that the doctor billed. The patient never agreed otherwise (remember?). So in the absence of an explicit contract, the patient is obligated to pay a reasonable cost for the services, not the obscene rack rate. Yeah I noticed it said “fair market value” and was wondering what that can even mean in the context of emergency medical services! ---
**Author:** ![hogarth](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hogarth/32/1773_2.png) [@hogarth](https://boards.straightdope.com/u/hogarth)\ **Post date:** [November 20, 2014, 12:43am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/49 "2014-11-20T00:43:21Z")
> [@Northern\_Piper](#): > > As well, some employers include out-of-country health care in their benefits package. After reading this story, I looked up my employer’s out-of-province emergency coverage. It has some language in there about not covering any procedure if you could have been reasonably sure beforehand that an out-of-province procedure would be necessary, but I’m not sure that’s true in this woman’s case (it sounds like her doctor okayed her). There’s also language in there about not covering procedures for women more than 31 weeks pregnant. ---
**Author:** ![robert\_columbia](https://avatars.discourse-cdn.com/v4/letter/r/e79b87/32.png) [@robert\_columbia](https://boards.straightdope.com/u/robert_columbia)\ **Post date:** [November 20, 2014, 1:17am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/50 "2014-11-20T01:17:05Z")
> [@Frylock](#): > > Yeah I noticed it said “fair market value” and was wondering what that can even mean in the context of emergency medical services! And if emergency responders were simply allowed to use implied consent to charge whatever they wanted, you would have entrepreneurial doctors trolling affluent neighborhoods waiting for some rich person to have a crisis. Swoop in, “accept” the patient, and send them a whopping bill. If they won’t pay, seize their yacht. Or their yacht and their summer home. Rich Guy: “One hundred thousand dollars to diagnose a broken bone, two million to set it, and three hundred thousand to write a prescription for a painkiller?” Vulture MD: “Yeah, that’s what I charge. I set my own rates. \ Entrepreneurship! Next time, check the rates of your local physicians before you stand in the way of someone else’s golf ball \. Also, I don’t accept personal checks, and I have a very strict late fee schedule, which I agreed to on your behalf while you were unconscious. Failure to pay in the next 15 minutes will result in a 50% penalty. Each additional quarter hour will result in another 50% penalty! It was agreed to on your behalf, I’m so glad we have implied consent here!” ---
**Author:** ![Shmendrik](https://avatars.discourse-cdn.com/v4/letter/s/ee7513/32.png) [@Shmendrik](https://boards.straightdope.com/u/Shmendrik)\ **Post date:** [November 20, 2014, 1:25am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/51 "2014-11-20T01:25:44Z")
I think a lot of people are lowballing the cost of modern intensive medical care. Here’s a somewhat outdated [publication](http://publications.gc.ca/collections/Collection/H118-38-2006E.pdf) by the Canadian Institute for Health Information discussing the costs of “giving birth in Canada”. According to the article, the woman spent 6 weeks in the hospital, followed by 2 months of NICU care for her baby. Page 11 of this report says: > [@Canadian Institute for Health Information](#): > > When there are no complicating diagnoses, the average cost per antepartum care > patient admitted to hospitalin 2002-2003 was $1,400 and the average length > of stay was 1.6 days. However, when there was a complicating diagnosis, the typical cost increased to $2,100 and the average length of stay was 2.6 days. So the 6 week antepartum hospital stay alone could easily cost $40,000. Setting outside the inflated “sticker price”, a day in the NICU easily costs $1500 - $2000, even in Canada, so 2 months of NICU care would be $90,000 to $120,000. (The document above discusses the cost of NICU care in Canada, but it doesn’t address costs/day so isn’t particularly helpful). So if this had happened in Canada, it would have cost the province of Saskatchewan something in the neighbourhood of $150K +. In the USA, insurance would probably have paid $200K - $300K. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [November 20, 2014, 1:32am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/52 "2014-11-20T01:32:09Z")
Due to the incongruity of the title, my mind keeps parsing it as “Canadian woman hit with huge **medicine ball** ”. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [November 20, 2014, 3:34am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/53 "2014-11-20T03:34:52Z")
> [@Qadgop\_the\_Mercotan](#): > > Due to the incongruity of the title, my mind keeps parsing it as “Canadian woman hit with huge **medicine ball** ”. Whereupon, huge _medical bill_ ensues. 🙂 ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [November 20, 2014, 11:13am UTC](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995/54 "2014-11-20T11:13:36Z")
> [@bob\_2](#): > > If she had come to the UK, she \*\*may \*\*have been billed for some costs, but would not, as far as I know, be pursued if she failed to pay. > > No one is ever charged for emergency treatment in the UK. There have been recent changes to the funding model in England, to encourage Trusts to recover costs from non-residents. I think they get something like 50% top-up on top of anything they can get? [Previous page](https://boards.straightdope.com/t/canadian-woman-hit-with-huge-medical-bill/704995.md?page=2)