Pregnant African Tourist Gets Support, Costly Treatment (over $1 million) From US Health Care System

[apples and oranges]

http://www.kaiserhealthnews.org/Stories/2010/January/05/immigrant-baby.aspx

For Jeanne d'Arc Kayembe, the trip to Washington in May 2007 was meant to be a month-long respite from an abusive boyfriend and a chance to visit relatives before going home to the Democratic Republic of the Congo to have her first child.

But searing abdominal pains sent Kayembe, who was six months pregnant, to Shady Grove Adventist Hospital. After relieving her pain, a doctor told her to stay in bed and not return to Kinshasa until after she had delivered her baby.

The Shady Grove emergency room was the entry point for Kayembe, who spoke almost no English and had little money, to a foreign medical system that was, by turns, both frightening and surprisingly welcoming.

Kayembe gave birth at Shady Grove to a very sick son, Don Emmanuel, who eventually got more than $1 million worth of care, mostly at Children's National Medical Center. U.S. taxpayers and the hospitals footed the bill.

:wow:

[NightWatcher]

1. happy to pay. we should be willing to help anyone/everyone

[spanone]

2. +1

[Bill219]

3. +10

[eShirl]

5. I'm sure the "pro-life" people would agree

if they are really pro life.

[piratefish08]

77. "pro-life" doesn't apply to poor people and soldiers.

says so in the RW playbook.

[CBR]

6. yes. nt

[BrklynLiberal]

11. and that inlcudes fellow Americans....

[lumberjack_jeff]

47. ... such as Don Emmanuel. n/t

[Posteritatis]

58. +1 (nt)

[Posteritatis]

57. Yep, this. (nt)

[ibegurpard]

4. what I would like to discuss in response to this is;

why does no one question the basis of the $1,000,00 price tag?
see, we're all questioning who should be paying for all this but why aren't we asking where they're coming up with these costs in the first place?

[depakid]

9. Interesting how Kaiser doesn't make a peep about that....

[BrklynLiberal]

12. EXCELLENT point!!!

[cbdo2007]

13. Hmmm, well a few MONTHS for her in the hospital....

and then it says she gave birth to a very sick baby, so I'm guessing probably a few more months in the hospital for both her and baby?

It sounds reasonable that perhaps she didn't need to be in the hospital that whole time but who are we to argue with the doctor's orders?

[ibegurpard]

14. you're missing my point

why is the price tag for a few months in the hospital and care for her sick baby $1,000,000?
Why not $50,000? or less? or maybe more?
what's the basis for the cost?
you're assuming the same thing every one else is...that the cost they're throwing out there is reasonable and justifiable
Ever seen an itemized medical bill?

[cbdo2007]

16. You think nurses and doctors work for free? You think they get all their machines

and drugs for free??

I don't doubt the costs are unreasonable but seeing as how the costs are a write off for the hospital for giving free care to someone without insurance, they're going to bill as much as they can so they can recoup all of this from the govt and from the taxpayers.

[ibegurpard]

17. stop coming back at me with "they have to recoup the cost"

when I'm questioning what the cost really is.

[cbdo2007]

23. Stop coming back at me with the assumption that it only costs a few dollars

to keep someone in the hospital for months and that "cost" and what is charged should be the same thing.

In her case, she is raising the cost of everyone else's care by not having the ability to pay for her own. So let's say the true cost of a night in the hospital there is $200 and she gets an IV drip all night that is $50 (obviously these figures are made up and simplified) so her total night stay is $250. She pays $0.

Let's say the person in the room next door had the same bill, $250 and she paid the whole thing. Even though the first woman's room only costed $250, the true cost for both rooms was $500, of which the hospital only recouped $250. Take this times 10 and they're going to have to raise rates the next year to make up for the true cost that they're never going to get paid for. The difference between this and a DVD at Best Buy is that you can't get a DVD at Best Buy unless you pay for it. For Health Care you can get the treatment first and never have to pay for it. Those costs don't just disappear.

[ibegurpard]

25. where did I say that I knew what the cost was?

that's what I want to know
then we can move forward
I want an itemization of that $1,000,000.

[Fire_Medic_Dave]

31. Intensive care, 2 heart surgeries, etc and the hospital ate 500 k of the treatment.

[malaise]

42. Excellent point

The costs are highway robbery

[Fire_Medic_Dave]

30. She wasn't in the hospital for months, the baby was.

[w8liftinglady]

44. thank you-I had $500,000 in bills last year

Thanks to my good healthcare-I wonder if the costs are tiered depending on funding?
and,yes-I am a nurse who understands the cost of care.I also know the insurance company/hospital will NOT lose money...

[noamnety]

7. k&r for doctors doing what's right.

The article's worth a read, I love that they don't discriminate against families based on immigration status, and that the hospital staff not only took care of the infant, but helped the mother get legal advice on getting asylum here.

I wish the title was accurate, however. A tourist didn't get a million in aid. Her son, born here, is a US citizen, and he received the bulk of that treatment.

[JI7]

8. why did it cost 1 million ?

[ibegurpard]

10. yeah, that's my question

and the question everyone should be asking about healthcare in general.
there's no justification AT ALL for the costs...just back and forth between providers and insurers with the blame being cast on the uninsured

[madmax]

15. That's the problem

We don't question medical bills (a lot of us) But, if your electric, water bill, etc. seemed over the top most of us would be right on top of it bitchin and screaming.

[Quantess]

18. My broken wrist surgery cost $22,000

back in 2008. One broken bone that needed a plate and screws to be properly set totaled $22,000. I didn't even spend the night in the hospital.

It could cost even more in 2010.

[ibegurpard]

19. And this is exactly what we need to be asking

why did it cost $22,000?

[Quantess]

22. Most people are surprised. Anyone not American probably would think I was lying about the cost.

The doctor did a good job, and the plate and screws were supposedly "new and improved", but really...I can't figure out why it was so expensive.

Probably nobody in Europe or Japan would believe me if I told them.

[jmowreader]

45. You know why

The plate itself probably cost $500 to make, assuming they made it custom--and that's what you'd almost HAVE to do because no two people will need the same size. Doc takes measurements, shoots measurements to factory, factory whips one out and sends it over. It could be cut on a waterjet machine in just a few minutes.

Installing it probably wasn't a huge deal either. That was probably one of those surgeries where the preparatory work took longer than the operation.

Malpractice is the problem. Thanks to all the personal injury lawyers and their "turn your hurt into a check" ads, if the doctor says it's going to take a week to heal enough for you to get back to work and it really takes two, obviously the problem is the doctor fucking up rather than you not eating enough vitamin K. So they set aside a shitload into a victim's compensation fund to deal with such emergencies.

[ret5hd]

68. What is the percentage of medical costs that go to malpractice insurance?

I bet you don't know, 'cause otherwise i KNOW you wouldn't purposely spread bullshit.

[jmowreader]

69. Consumer Reports says two percent...

I didn't realize it was that low.

I wonder then what it really was, since at the end of the day you're still looking at a piece of titanium someone whipped out on his waterjet cutter for $500 total, and a very short surgery to install it.

[ret5hd]

70. I appreciate your response...

and even more appreciate that you took the time to research and honestly report (in the subject line, no less) your findings that were contrary to your original assertion. Such effort and intellectual honesty is too lacking here lately, and maybe it has me a little too much on edge.

thnx,
ret5hd

[Control-Z]

24. I just went through the same.

Still in physical therapy. I haven't added up all the costs yet, but the wrist surgery, plate and screws, came to just about 22,000.00. That is without adding in the ER costs, tests, x-rays, therapy...

[Quantess]

33. Right, the 22,000 did not include my trip to Immediate Care, or physical therapy after.

Do your plate & screws resemble a small hairbrush? LOL, mine does.
I was in such terrible pain for weeks. I used to show people the x-rays for sympathy, saying, "look at this thing in my wrist".

It took months to regain the flexibilty and strength, but amazingly, my wrist is like new again. And the scar is almost invisible now.

The doctor said that it could be set without the plate & screws but it probably wouldn't stay in place. I'm so glad I went ahead with the deluxe surgery, but, if I was stuck with the $22,000 bill, I'm sure I would have filed bankruptcy. I can't imagine opting for the mediocre non-surgical setting, but I guess some people choose that option because of the cost. Sad.

[Control-Z]

72. I have to admit -

if I had to pay the entire bill I'd also go bankrupt. I actually have a lawsuit pending that will help absorb my share of costs if I win. (fingers crossed)

I've had three children, 4 lower back surgeries, other broken bones over my life, but this wrist surgery was surprisingly, horrible. I was shocked with the amount of pain. They did re-break the bones so I'm thinking that had something to do with the pain. The doctor had hoped to go in through the top of my wrist with small holes, but as you can see he ended up doing the big cut from inside the wrist. He also wanted to do surgery on the other wrist at the same time that had a small fracture in one of the tiny bones, but I refused. The pain was improving and I just couldn't fathom both wrists.



I only got a glance of the x-ray after surgery but the plate was bigger than I expected. It it noticeably painful, but different, like I can feel it poking me from the inside. Ew.



The plate looks something like this?

Did you actually break the small bones of the wrist? It was my arm bones, where they meet the wrist, that I broke on the one hand - small wrist bone on the other.

Thanks for telling me about how well you've healed. I've been very frustrated and lost a lot of time from working and doing so many other things. It is improving but now I feel like it will improve to a higher level than what I've been expecting.

Amazing how the loss of hand movement can change everyday life. Like zipping up a pair of pants or putting on socks. Lol.

[Quantess]

74. The plate looked like a hair styling tool in the x-ray photos.

I looked at the post-surgery x rays and I said "no wonder it hurts so bad". I was crying from the pain the first week. I broke the radius bone of the arm right at the wrist. It's hard to believe it now, but I guess my arm looked as bad as yours at one time. I didn't have a plaster cast, though. The doctor opted to have me wear a brace instead.

[Control-Z]

75. It sounds like you broke yours

almost exactly like mine - the radius and the ulna right where they meet the wrist - in three places. There was a lot of splintering. And I too actually cried, it hurt so bad. Not when I broke it, but from the surgery. I felt like a baby, but I had a mean recovery nurse who really didn't care that it hurt and that made me cry even harder. I'm so glad you've healed up so well and have moved beyond the pain. I know how much you must have hurt.

[madmax]

37. I can relate

had glue injected into my sacrum for a fracture cost: 22k for crazy glue ;) 3 hours in day surgery. I'm grateful for the pain relief but, WTF!!

[Quantess]

38. Of course we are grateful for excellent health care. It is priceless!

But that begs the question, how much should good health care cost? Should it literally cost an arm and a leg because it is so vital, or should it be affordable for everyone because it is so vital?

What is the point of civilization if the average citizen has to worry about not being able to afford optimal health care? Are we Americans or are we a third world country?



(I just exceeded the question mark limit)

[Fire_Medic_Dave]

29. The kid was in ICU for months had 2 heart surgeries, CHF, HTN and cogenital defects.

[nadinbrzezinski]

20. People have no clue about health care costs

one million for two heart defects, surgery and developmental therapy is not outside the norm.

It should cost less, perhaps, but it is not OUTSIDE THE NORM.

Hell, I saw my dad's bill... after he broke his hip... and I was off by 20K... I expected it to be 20K more than it was.

Or for that matter, for those of you who have insurance... tami-flu, the cost of the five day course is 98 bucks... but I'd not know if I did not ask, since it ran me nine bucks for the deductible.

[ibegurpard]

21. you're right we don't

and we should
"it's not outside the norm" does not mean that the "norm" is justified.
why does it cost $20 for a wooden tongue depressor? to offset the cost of treating someone who was uninsured? why was THEIR care so costly that we have to bump up the cost so much?
I understand this can turn into pointless navel-gazing but we have to stop just taking it for granted that the costs are what they are.
Right now the healthcare providers just charge whatever and the insurers either pay or they don't.
why are the cost of drugs what they are? research and development? do you want to know how many parties and receptions I've worked where pharma reps have spared no expense wining and dining prospective clients in the healthcare industry?

[TreasonousBastard]

27. I've been talking about this every time I have a chance, but...

as you've seen, few really seem to care.

Everyone complains about what they see, but few bother to understand wht's behind it all. Insurance too high? Sure, that's obvious so complain about it. But, the insurance company just got stuck paying half a million a year each for a few cancer patients getting a new treatment, and expects a lot more-- no one sees that cost behind the premium increase.

Some insurers and policy makers believe in copays so that the patient has some clue about costs and might just slow down on demanding every diagnostic and treament known to medicind.

There's a fatal error in a lot of thinking around here that we actually can afford to pay for any treatment for any patient who demands it. We can't-- no country can, but especially us with our costs so high.

[cbdo2007]

35. Right....everyone assumes that because you can get a thermometer at Walmart

for $5 that the hospital should be able to treat Swine Flu for about $10.

I used to work for a health insurer and worked on a specific project once where we looked at all of the people in our system with the most ER visits, like we would pull out anyone with more than 10 ER visits per year dealing with "pain". We had people in this report that were going to their local ER 3-4 times a week complaining of stomach pain and not just a couple of people but 100+ of our members with all of these miscellaneous ER visits.

We found that the majority of these people had mental health issues and their ER visits stopped after we had mental health professionals contact them and set them up with appointments with therapists. This was literally hundreds of thousands of $$$ that were being wasted on these people who knew they could go to the ER anytime they wanted and that they would run a sh*tload of tests on them and demand all of these other tests and the hospital would do it and the insurance would pay for it.

Well, where do people think this money comes from? It costed the hospitals hundreds of thousands of dollars and the insurance company hundreds of thousands of dollars on 100 members so they have to raise costs and raise rates on everyone else to make up for that.

[nadinbrzezinski]

28. Some answers to your questions and in advance sorry for the formating

and we should
"it's not outside the norm" does not mean that the "norm" is justified.

No it is not, it should be far less and here is where it should go down.

why does it cost $20 for a wooden tongue depressor? to offset the cost of treating someone who was uninsured? why was THEIR care so costly that we have to bump up the cost so much?

Yes and yes... the problem is that you still need to pay the bills, and every patient that shows with NO MONEY and that does not quality for government programs, or does, but their schedule is lower than actual cost, it means that you and I get to pay.

That said, if all your population IS insured that alone will drop costs... depending on the analysis made all the way from 50 percent to oh eighty percent. A lot of the actual cost on overhead depends on things like commercials, and administrative costs. Why Tricare (and the VA) are far more efficient. They do not have to run adds for example.


I understand this can turn into pointless navel-gazing but we have to stop just taking it for granted that the costs are what they are.

I did not say they were right. Just that in the CURRENT environment this is not surprising. I was a medic with the Red Cross in Mexico, where profit was the last thing in our mind and some costs are high regardless. I mean we did the exercise one day of actually calculating the care of a code trauma (people who are close to death when EMS shows up) To our shock our cost was not that much lower than the US. At the time, we came wiht about 4K for the critical care run... just based on basic cost of equipment, training, gas... vehicle maintainance and all that. Granted, Emergency Medical Care IS one of the most expensive to provide out there... but it is NOT the norm. So yes, a code trauma will run the crew oh in today's dollars 5K (using bulshit numbers to a point) but after that patient enters the hospital environment that is where the cost differential gets crazy. that same patient will run an average of 10K in Mexico, ok 20K perhaps if you take into account long term therapy and recovery and yes income loss (which usually nobody takes into account). In the US that same patient care can go all the way to a million plus and no income in the equation. That is where things are broken...in major ways.

Right now the healthcare providers just charge whatever and the insurers either pay or they don't.

Wrong, health care providers do not charge whatever, they charge what schedules tell then they can from insurance and government sources. This is one of those very large misconceptions out there. Especially doctors working at a hospital... and the fee schedule in that case is not even set by the practitioner but the bean counters at accounting. And insurance companies fight fee schedules all the time and try to keep them low. Add insult and realize that some fee schedules, such as medicare, have kept up with Cost of Living and inflation not medical inflation, why doctors cannot truly afford to take those patients. Not justified but to diagnose the problem, no pun, one has to known how this works,


why are the cost of drugs what they are? research and development? do you want to know how many parties and receptions I've worked where pharma reps have spared no expense wining and dining prospective clients in the health care industry?

No it is not R&D and I've had this conversation many a times with brother who IS a doctor. R&D is partially funded by your taxes and mine through NIH. The high cost comes from the commercials. Wining and dining doctors is actually a lower cost. But those commercials for oh Viagra is what drives the cost so high. Oh and there is more, the same drug that costs you for the sake of argument, five bucks a pill in the US run you a buck fifty in Canada... partly it IS regulations that well WORK.

Yes I have sent my congress criters a here is what are the problems with health care and why I am all for single payer... and it will bring costs down, but it will create a few other issues. Of course they will be magnified beyond belief by the right, but that is another matter of discussion. I just know that they will happen.

[ibegurpard]

32. thanks

these are the kind of discussions we need to be having

[nadinbrzezinski]

36. I have become a policy wonk

and yes, we should, and that is what the scoring is doing.

[Horse with no Name]

26. I've talked to many Americans who utilize healthcare in other countries

when traveling and they usually are pleasantly surprised that their needs are met without hassle and without cost.
I don't understand the issue here?

[Maru Kitteh]

34. Hey Apples and Oranges - NICE DRIVE BY.

Duly noted.

[Quantess]

39. Maybe OP was afraid of the reaction?

[hatrack]

54. Also, WTF does the fact that she's from Africa have to do with anything?

"Tourist" would have worked just fine - that's just Flamebait Headlines 101.

:eyes:

[SemperEadem]

67. exactly--I don't see what her being from Africa has to do

with her health or the health of her son.

It's one of those "Us against Them" divisive bullshit fear-mongering crap.

[Shanti Mama]

40. I'm amazed a 6 months pregnant "alien" got a visa

Most consulates would deny on the grounds that she intended to give birth in the US so her child would be a US citizen.

[noamnety]

41. Not sure why you are amazed

It's right in the article: "Visa applicants are not asked whether they are pregnant."

Speaking as someone who has traveled overseas while pregnant, I'm glad our government doesn't take the position that women who are pregnant are suspected criminals and con artists who shouldn't be allowed out of their country.

[Shanti Mama]

43. Sorry. I didn't read the article, just the post.

I live in a 3rd world country and any woman here who was showing a pregnancy would probably turned down. The Consular officers don't need to give any reasons, any explanations. If they think the person is a flight risk they deny the visa. So about 97% of applicants are turned down, after paying what to them is a handsome sum of money to apply, nonrefundable.

I didn't mean to imply that pregnant women are suspect. Just that our consular officers often aren't very kind in the way they deal with people.

[noamnety]

56. Ah - thanks. I understand that.

Sorry for making wrong assumptions about the perspective you were writing from.

[Shanti Mama]

76. No problem

Thanks for the apology. I always try to be really careful with my words here. Will try harder.

[lumberjack_jeff]

46. Don Emmanuel is a US citizen and entitled to everything I am.

The $1m in care was not provided to Ms Kayembe, but to her son.

There is nothing wrong with this, except for the reality that although the care cost $1m, it should have been much less.

[Romulox]

48. An American would be "entitled" to file Bankruptcy after this.

And parents are liable for the medical care of their children, so a US citizen would be at a distinct disadvantage here--there's a good chance this baby would've died had it born to an American citizen. :hi:

[lumberjack_jeff]

49. Our system sucks

... but your assertion is silly. If mom didn't have insurance, the child would have been placed on state medical with the assistance of the hospital tout de suite.

[Romulox]

50. You're delusional if you think that poor people get the best care "tout de suite"

without a question as to who's paying.

[lumberjack_jeff]

51. What point are you trying to make?

That Don Emmanuel got better care than other US citizens do? Why?

Reading between the lines of the story, it seems apparent that his insurance coverage comes from the state.

[Romulox]

52. That reality doesn't match your spiel.

"That Don Emmanuel got better care than other US citizens do? Why?"

Because Don Emmanuel's US parent may well have been crippled financially by the process (for a minimum of 7 years)--or, as the charts indicate, in many cases, he simply would not receive this sort of care at all.

[lumberjack_jeff]

53. Mom was already poor.

Nevertheless, her son got adequate and expensive care. This is partly because he is a us citizen and entitled to public assistance.

You haven't given any evidence for your assertion that his situation is somehow unique.

Of course any normal person handed a $1m hospital bill would declare bankruptcy, but bankruptcy isn't really the point of the OP. The point of the article was to try to muster outrage that "an african tourist" got such a sweet deal courtesy of US taxpayers.

The subject was patently false, because it was a us citizen who got the sweet deal.

Those on public coverage have a better chance of having their major illnesses covered than those with private insurance.

I'm having a hard time understanding what your problem is.

[Romulox]

55. We don't have "public coverage" for a huge swath of Americans...

"Those on public coverage have a better chance of having their major illnesses covered than those with private insurance."

We don't have "public coverage" for a huge swath of Americans. Nor is it being proposed. Again, it seems that if this need be pointed out, there is no point...

[joeybee12]

59. It's from kaiser...does anyone really think most of this is accurate? n/t

[dembotoz]

60. oh it would be that much if you did not have insurance

with the discounts the insurance companies get from the hospitals i would imagine much much less.

[joeybee12]

61. I just think whatever happened -the whole story--is not here in this

article, as Kaiser obviously has an agenda.

[Earth_First]

62. The overt racist xenophobia in your OP is disgusting!

Return at once to where you come from!

[noamnety]

63. I'm not disagreeing, but I want to point out the subject line here is the actual headline.

There was no editorializing in how it was presented here.

So there's a level of concern if people are buying into that viewpoint from an anonymous internet poster - but the larger concern should be why kaiserhealth is presenting the story this way, what are they looking to stir up, and why?

[Earth_First]

64. Yes, but there was no opinion given by the OP

which allows the information presented by the OP to be that of their own opinion.

Classic drive-by thread.

on edit: spelling error

[SemperEadem]

65. A friend of mine's grown daughter just spend 4 days in the hospital

and the cost is going to be over $5,000. She has no insurance and my friend is going to end up paying out of pocket for it.

It is not surprising that hospital stays are prohibitively expensive and have been.

[Fleshdancer]

66. Good.

What do you think happens when Americans who visit other countries have sudden medical issues? THE SAME THING. It's the Hippocratic oath at work and it takes place all around the world.

[Karenina]

71. For anyone who hasn't been on DU long enough to notice...

THIS is called a "hit and run" OP.

[lightningandsnow]

73. EVERYONE deserves healthcare.

That's right, not just every citizen. Every person, regardless of immigration status or country of origin.

[jmm]

78. American women can be confined to the hospital while pregnant but

an article about an African woman highlights the cost. Our nation has some nice priorities x( .