07 February 2008

Detaining Patients Who Can't Pay

Not 2 or 3 babies, but 6! 6 babies!! Can you believe this?

The crestfallen fates of poor families are highlighted even more when their babies are held as "guarantees" or "living collaterals" when they fail to settle their hospital bills. This happens all the time in many hospitals here. If this were a movie, the tag line will probably be, "If you can't pay, then you have to stay!" I have always thought that the problem lies in the murky overlap of two conflicting doctrines: what constitutes humanitarian care and what it means to run a business institution (like a hospital).

There are exceptions, of course. If you happen to be the relative of a hospital officer, or if you are part of the hospital administration staff, or better, if you are a famous, rich, and powerful member of the elite society, then, you can probably get away with it temporarily. Not only because you can pay easily, but because even if you delay paying your total hospital bills, the hospitals will probably trust that you won't run away.

Money = Trust. That's the case most of the time. Influence, a big name, and power count, too! If you have all of them, then you have no problems getting "illegally detained" inside a hospital.

But hold your horses! In my opinion, it is also incorrect to portray hospitals as mere "kidnappers" waiting for ransom payment. If you hear the side of hospital administrators, they will show you many cases in which patients "they freed" or allowed to leave without complete payment of the total bill didn't return at all. Those with promisory notes also fail, and soon, what the hospitals end up with are nothing but a pile of broken promises. So, you can understand them why they behave like "kidnappers". If you run a hospital business, then you must know that it is essential that you earn money, too. If everyone runs away after treatment, then these hospitals suffer and can end up closing down for good.

A socialized fee structure or a buffer fund might solve or ease up this problem, but since many "patient detentions" still happen, I think the problem is deeper than we perceive it to be. The sheer volume of poor patients might be outnumbering those who can pay. Also, maybe there are more hospitals on the verge of bankruptcy than we really know.

It is a very difficult problem. The hospital administrator always end up torn between being charitable or being a sly businessman. In the case of the babies being freed using the habeas corpus legal remedy, I think that is a better outcome. At least now, the babies are finally free, and because the case is now handled by the court, I think it will also now strictly supervise and see that these babies' hospital bills get paid too in due time.

2 reactions:

rolly said...

This is really a problem as the issue is pegged in between two opposite ends whereby survival is at stake. Survival between the hospital and its business and the parents who have nowhere to go for a safe delivery. It is very sad that people should be trapped in this kind of a situation.

bayi said...

Similar to this situation, I had a friend whose wife suffered from cancer. She was admitted to a private hospital. She was treated and charged tens of thousands of ringgit (Malaysian dollars). Unfortunately she died and there was an outstanding bill of one thousand ringgit. In his grief, the husband told the hospital that he would come back to settle the bill after the funeral. After all, he had already paid the hospital tens of thousands of ringgit.

But NO. The hospital would not release the corpse unless the final bill has been paid. And there was no room for negotiation.