Monday, January 9, 2012

Medical Bankruptcy

I decided to comment on a friend of my brother's FB page today when he was discussing America's medical system with his american friends... I noticed that he said our healthcare has always been 'free' and I felt the need to go in and post that NO it is not free. Maybe I should have respected his page and kept my mouth shut, but then again, he allowed me on his page and he posted 'publicly' and then made a mis-statement that Americans who are unfamiliar with our system will not understand. I discussed that we pay more taxes to cover this and about 47% of Canada's tax revenue, reportedly, goes to the healthcare system and it's always increasing. Gee then we wonder why other things get cut, but I digress. My point is that in the end, he basically asked me to stop 'debating' on his page. I felt like I had been slapped in the face. I'm supposed to sit back and watch him tell his american friends that our healthcare is 'free' and not talk about the resulting short comings. But whatever, boohoo to me.

What I did note was that one of his friends said that medical debt is the highest debt for US citizens. That is not true! Um how about MORTGAGES? Geezus murphy. So I went online for awhile checking recent documents in relation to personal debt in the States. It's quite confusing but I did find a 'Harvard' report from 2004 or 2005 that said the highest reported link in personal bankruptcy in the US is medical expenses (stating that about 54% of those filing personal bankruptcy had medical expenses in their list). In Canada it was far far lower.

But upon further investigation, I read several accounts where when they looked at the stats used for the report, some people only had a $5 or other extremely low medical debt in their list. Other things like vehicles, homes, and credit card debt, added up to a much higher percentage. So then I wondered how many of those people had medical expenses as their number ONE reason for filing. I had a very hard time finding that info.

I am well aware that in Canada, there are people who filed or almost had to file for bankruptcy after waiting for very long periods for treatment and being unable to work in the meantime (ex shoulder and back surgeries and even cancer treatments). There have been 3 stories in my local paper over the last year detailing those very kinds of stories, because people were losing their homes while being on reduced income while awaiting treatment. But I had no idea what the stats were. So I trolled around some more and found an interesting paper by the Fraser Institute. Yeah yeah it's called a right leaning think tank, but it has factors to consider while trying to get to the bottom of this.... 'The Medical Bankruptcy Myth'....

Everything has it's spin, I realize that, but I can just look around and listen and read articles and know that it is not all roses up here either. And I am well aware that many studies end up being picked apart and you have to be very careful what you take in. Like years ago when I did a paper for college about why baby walkers were banned in Canada. The same study kept appearing as a basis for the decision so I finally tracked it down and discovered it was a study done on TWO children, twins. The twin who was allowed in a baby walker walked later than his brother,,,,, two weeks later. Oh boy! I didn't know that twins were supposed to walk on the same day,,, just because they were twins! That  is amazing! Anyway that study appeared over and over in publications regarding the ban (stats on accidents were the priority, but it also stated repeatedly that baby walkers were also bad for a child's physical development, and quoted the study I tracked down). What a crock of baloney! I should also note that over 90% of the accidents involving baby walkers were due directly to lack of parent supervision (such as the number one accident - falling down stairs while in a walker). My rambling point is that just because a 'study' was compiled does not mean that it was scientifically sound and considered all variables necessary and related to ensure a valid outcome. Do not be fooled. Check them out for yourself!

 ----------- Jan 10 update

So I was perusing the comments on that FB page and I had to sit on my hands to keep myself honouring the poster's wish that I not contribute further.... He had asked Americans about the cost of various services and how it all works. One woman said that a family member works in hospital billing and gave him some quotes. One jumped right off the page at me. She wrote on behalf of this family member that a premature infant can cost $400,000. That topic is close to me because my last child was a preemie. I am a member of several Preemie Parents groups and by far the majority of members are american. There are whole threads where they discuss cost and I have never seen a total higher than $250,000 (and that was an extreme case with a micro prem born at 22 weeks with a LOT of medical problems including heart surgery etc). So I did a little digging.

The first places I hit were like March of Dimes and so on that focus on preemie issues. They state all over their site that the average cost in the US is $50,000. I have seen the avg quoted as high a $64,000 (2009 data). Okay so where the heck did this $400,000 come from? It seemed so outrageous next to the poster's other costs, it was baffling me (eg, cancer diag and treatment $100,000, heart attack $50,000, etc). So I finally found some data saying that the average cost is $50,000 but they can go as high as $400,000. If you think about how averages work, there must be an awful lot of preemies born that cost far BELOW $50,000 in order for that number to come up. So while the poster stated a truth (that it can cost $400,000), the operative word here is CAN. Obviously that is a very high cost that happens to very very few people, only in extreme situations, or the average cost would be higher, would it not? So that's the kind of thing I do not like - basically posting scare tactics.

I looked up the average cost of a preemie birth in alberta after seeing that those American averages also include delivery and the first year of the child's birth, not just their NICU stay. I figured out based on looking at charts online for alberta that my son probably cost the province a mimimum of $37,000. That was based on the average cost for a straight forward csection, and $1500 a day for 15 days he was in NICU, based on what his own RN's told me the cost was to keep him there. My son was a very healthy preemie. He did not need any major intervention, was only on oxygen for an hour, and only had to be kept warm and fed. He had a saline IV for fluids, but no medication and no emergencies with his heart or lungs. So he was a pretty darn cheap preemie compared to what happens to many (air ambulance, hospital transfers to Calgary or Edmonton, interventions for heart and lung issues, etc) - and it still came out at $37,000 which is not far off the US average cost. No I did not have to pay a bill directly, but the other part of the news about healthcare problems in the US also states that the costs are unnecessarily high.... well apparently Canada's costs are high too eh? I saw a sign in the register office at the hospital that said uninsured out of province parents would have to pay over $3000 a day for NICU and out of country patients would have to pay up to $6600 a day for NICU stays. Boy things sure are cheap up here! Must be because govt is so good at reducing costs - haven't they proven that over and over? Bah!

Anyway my point is, the grass is not always greener on the other side. I have posted in my blog before about how the hospital pretty much forced us to take our son home when he was still 5 weeks premature, weighing only 3lbs 9oz, because it cost $1500 a day to keep an otherwise healthy baby in hospital. We were terrified! We did not let ANYONE come to see him until 6 more weeks had passed and he was gestationally one week old (but he was really 8 weeks old), and my older children had to strip their clothes off the minute they came home from school and wash up to their elbows before they could touch him because a simple cold could have sent him right back to the hospital, or worse. That's what happened to us because we do not have a choice here. We cannot even attempt to keep a tiny baby like that in hospital if they don't want him there because the doctors are always hounded for cutting costs when they can.  There is no extra insurance to fall back on. The only thing we could have done is pretend to be incompetent. If the staff was worried we would not take our son's care seriously, they could petition the doctor to keep him there until they were sure it would be okay. But that would mean pretending we were idiots and we could not bring ourselves to do that. I passed my 24 hour check with flying colours, and they stuck him in a car seat padded and lifted up with blankets (against all car seat safety information), and send him home. To save some cash because you know, our system is so much better :)


  1. our health care, medical care system is everybit as expensive as the u.s. we distort the facts and the sheep buy it. the toatal cost of health care is never really looked at. we say we spend 46 to 47 percent of government revenue for health care but there are many costs outside that dollar figure. i would love to know how many dollars are really spent.

  2. I would love to know as well. And I suspect people would find that a heck of a lot of money goes to things outside of direct health care such as the committees and bureaucrats involved in deciding how things should go - not unlike people complaining in the US that essential services keep going up in price so that others can profit. Or in the US there is also a problem of hospitals increasing fees for some services to try to cover the cost of serving the uninsured patients they are obligated to attend to. Not unlike our system, whether we have premiums or not, where people who do not contribute to the tax system use the health services and someone else has to pay for it (via increased taxes, less services, etc).



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