I was referring to medical travel insurance.
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.
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.
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.
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.
Ontario air ambulances have been known to pick up injured Canadian skiers from Minnesota, so as to avoid the American health care system entirely.
Yeah I noticed it said “fair market value” and was wondering what that can even mean in the context of emergency medical services!
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.
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. <smiles> Entrepreneurship! Next time, check the rates of your local physicians before you stand in the way of someone else’s golf ball <chuckles>. 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!”
I think a lot of people are lowballing the cost of modern intensive medical care.
Here’s a somewhat outdated publication 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:
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.
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. 
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?