Their baby was born in an American hospital seven weeks early, but the couple said Zurich Insurance Group refused to uphold the policy and cover their costs because the baby was not named in the document.
After a nine month legal battle, Zurich has reversed its decision and told the BBC it was sorry for the stress caused.
post
After a nine month legal battle, Zurich has reversed its decision and told the BBC it was sorry for the stress caused.
Yeah, very sorry I'm sure. Oopsie, we accidentally fought a nine month legal battle to avoid paying out the exact thing the insurance is for
"We've now strengthened and clarified our wording and guidance so other families travelling abroad at this stage of a pregnancy do not have to go through this experience."
TLDR: the next couple is fucked
No, what this means is that they have increased premiums for anyone at 33 weeks of pregnancy and added something about premature births that will cost more if you're traveling to America. Either that or put in specific language excluding coverage for premature births. Either way, insurance companies are a scam.
Arguing the care wasn't covered because the baby wasn't named in the insurance despite explicitly covering pregnancy-related care is ghoulish behavior. I can't fathom how you can argue that seriously and not feel like a piece of shit.
Do not travel to the US
The problem in this story wasn’t actually the US this time, it was the Swiss insurance company.
I would say the problem also was a very high medical bill of $ 200k.
Yes. You're right. Our healthcare system is absolutely bonkers bananas insane, and that's before you calculate in the cruelty. And as US citizen, I strongly advise everyone who isn't to avoid this country like the plague.
However, if I travel to Switzerland or Canada or Italy or wherever, as a tourist, I am not covered if I go in the hospital. I still need to carry travel insurance, and if I don't, or if it doesn't cover something, then those countries with their modern, sensible healthcare systems will charge me out of pocket, just like an American hospital. The difference is that in America, even the citizens aren't covered by default, and the amounts are astronomical compared to other countries.
It's a shitty system all around, and frankly, I genuinely believe that if it weren't for America's weird fetish for as much money as you can possibly choke on, we would probably have started building an actual universal healthcare system for the global community, so that you're covered by default even when traveling. But like with most things, the right wing nonsense has held us so far back that that is so unlikely as to seem utterly impossible
Yes if you come here to Danmark from the US you will not be covered. But if you are from a country in the EU you will in most cases be covered and don't have to pay anything for being hospitalized.
Even if you do have to pay something, the cost Ive seen people post in europe are in the hundreds/thousands, not hundreds of thousands like the US.
Maybe this couple woukd have gotten a $200/2000 bill in the EU for a birth? $200,000 is a purely US problem.
It's complicated, because it's American healthcare.
The hospital charges $200k. The insurance agrees to pay a negotiated discounted rate of $100k. $75k goes to the various insurance plans of the doctors and hospital. $15k goes to the people providing care and materials costs (everything is itemized, so then $50 aspirin you see is because it includes the time of the pharmacy tech who got the order, entered it into the system and checked for interactions, the tech who filled the order, the pharmacist who had to sign off on it, and the nurse who carried it to the patient.). $10k goes to the hospital as profit.
The insurance then makes the patient pay their $5000 deductible, which is what you pay before the insurance you pay for pays for anything, then the patient pays their $2500 coinsurance, which is what you pay after the insurance you pay for starts to pay for things but they only pay for half. After that the insurance covers it. The "perk" is that having met your deductible and coinsurance costs you likely have to pay little or nothing for care for the rest of the calendar year, making January to most financially responsible time to have a medical emergency.
In terms of actual "cost", I think the biggest difference is the itemization of everything. Universal healthcare is intrinsically more cost efficient, but it still has to pay doctors and nurses. When that cost is viewed as part of the cost of running a hospital as opposed to part of the service "charged" to the patient it can bring the "list price" down a lot. You end up with the price of a broken arm being the cost to treat a broken arm, not then cost to treat a broken arm and have everyone involved show up and your share of building the hospital room, and the cost of the janitor cleaning the room.
If I'm going to be paying $200,000 for medical procedures then they better be replacing my liver or something. How could a pregnancy possibly cost that much money?
They probably asked 6 grand just for pulling out a splinter.
NICUs are capital and professional labor intensive. I got to meet the team of doctors and nurses who kept my son alive and thriving for the three months between birth and due date. Idk what the magic number to care for him should have been, but I don't think six figures is an unfair estimate in any socio-economic system.
The question after that is "Who paid for it?" And, in my case, it was Medicaid, which was a huge relief. These poor bastards clearly didn't have the option.
Why it's so capital intensive is another issue, but the matter of six figures being reasonable is to compare that to costs of similar treatments in other countries (usually it's an order of magnitude more expensive).
Healthcare just can't be free market bcs the demand side cannot be free by definition.
A big part of that is that other countries view to medical staff as a fixed cost. They're not reflected in the "bill", much like how you don't get billed by the fire department. They're simply paid to be there, and costs for treatment are more reflective of the cost of the treatment.
Was likely 2 hours a day actual attended care, 1000 a day, 90k for 3 months, plus rent, food, materials, another 500 a day. That's $135-155k even with conservative care in nicu. In a real nicu that would be 10x
My nephew was also in the nicu for three months, and he cost a million dollars. Also picked up by Medicaid. As much as I hate the US Healthcare system, I will be forever grateful to the united states of America for providing life to my nephew when in any other time or situation he would have just died immediately. He is and continues to be a miracle, a very special, bright boy who just scored a goal for his soccer team this weekend for the first time.
why would you go there??? this couple was asking for it
Did you see how they were dressed my god
If i take a boat and sail to a known cannibal island, where people like me have gone and been eaten before, and I then get eaten, there's no one to blame but me. The US is simply not a good place to travel to at this time. It would have been even more hell for them if they had to over stay their visa.
I don’t see how this is the US’ fault. Their insurance, who initially denied them, is with a Zurich company. Do they expect any country they visit to cover them medically?
Maybe I’ll pop over to Berlin if I ever get cancer. Surely they’ll pay for all my treatments even though I’m just a tourist. They aren’t barbarians like the US.
I'm fairly sure in Berlin they won't charge you two hundred thousand fucking dollars for an emergency procedure, but sure, go on strawmanning. What the hell.
Sorry to burst your bubble of USA-hatred but nope. Germany will not decline to treat you but they will bill you. Oh wait… that’s exactly what happened in the US! This was not just an emergency procedure but 3 weeks in the ICU.
This couple’s insurance ultimately decided to pay. So this is a total non story. It would have happened the same in a million places. Tourists do not get major services for free. If they did, people from around the world be showing up with conditions and just reporting straight to the ER and then hop skipping home.
This story was drummed up to tap into people hating on the US for its poor healthcare system. Which is usually valid. But if we judge by whether tourists get free major services, the US isn’t any worse off.
The costs are not comparable, otherwise or healthcare systems would all be bankrupt. And here we don't have the same incentives to inflate costs.
Yes the costs would be different. Perhaps 100,000€ instead of $200,000. The fact remains tourists don’t get free healthcare anywhere.
This is a complete nothingburger of a story. The couple got treatment. Their insurance was billed, exactly as it would have been if they’d been in Canada or Portugal.
Their insurance momentarily denied to cover them. Why aren’t we mad at them? Because this clickbait story was created to stoke a pre-existing “America sucks” narrative and get outrage clicks.
And they seem to have played everyone here perfectly.
Maybe they denied to cover them because of the ridiculously high bill, have you ever thought about that?
Edit: It seems the cost of a normal birth in Germany is at most €7500 for a tourist with no insurance.
Helllllo the baby was 7 weeks premature and in intensive care for 3 weeks. The cost of a normal birth is totally irrelevant. You didn’t read the article, obviously.
I paid literally zero for either of my kids births right here in California.
According to this study, the mean total cost of NICU in the UK for preterm babies at 31 weeks gestation is £27,401 and tourists should get charged the same if I'm reading this correctly.
So no, not even close to $200,000 or even the €100,000 you pulled out of thin air. Clearly this is reason enough to believe the cost of the healthcare in the US is what made the insurance company try to avoid paying. I don't know why you're defending the healthcare cost in the US without even doing a bit of research of how it normally is in Europe where the couple and the insurance company comes from.
My grandpa had a peacemaker installed, we received a (paid) bill for the cost of the operation (idk why or how, but I remember my mother showing it to me), it was 36k€. Sure the stay was shorter, but it's also heart surgery on a frail patient with lots of other issues.
How much shorter was the stay? Maybe we can apply some multiplier. At least the example you’re offering is a fully loaded in-and-out final bill, but all this trying to compare the costs of different medical procedures is fumbling in the dark. We know medical costs in the US are higher, and we usually know by how much. The numbers I see in a quick search are $13.4K per capita annually for the US and $9.6k for Switzerland, likely with better outcomes. Was higher costs the reason this couple’s insurance declined them? Maybe. It’s a fair guess, but that’s all. If someone wants to tell me there’s never any back and forth with their EU public health program before a bill gets paid, nor with the private insurance carriers every EU citizen that can afford them also has, then wow, that will have been the best thing I’ve ever heard about healthcare in the EU.
Whether cost was the sole issue would have been a great question for the reporter to ask someone. But as you can see, they don’t even need to work that hard at their job to get the outrage clicks they need.
used to be anchor babies, now is trapped in debt babies
Just don't pay, what are they going to do?
As artists that go on tour, the US leg likely provides a significant chunk of their income. If they were just on vacation, that's a different story.
Worth figuring out for them, as it boiled down to an administrative issue with unclear wording in the insurance contract.
I mean given all I hear it would not entirely surprise me that they would hold the baby hostage, at best
Hospital: we gonna steal ur baby lol
Parents: oh no, you are going to feed it, bathe it, care for it, educate it, all on your own dime? Oh the humanity
Hospital: wait no not like that-
E: hospital: that's filthy socialism!
Convict you in absentia then use the judgement as an excuse to freeze your bank account and ban you from all forms of banking (something that the US has the power to impose on foreigner because they hold every western bank by the balls due to their reliance on the fed)?
I don't know if they would do it, but it certainly wouldn't be unconstitutional; the US have long made it clear that foreigners on foreign land don't have any legal rights whatsoever. I would be having a long conversation with lawyers to get some hard assurances before going down that path.
Exactly. You're already outside of the country. Let them send you bills. They aren't going to send the FBI to kick in your door because of unpaid bills...
"I don't think we've ever sort of lost the feeling that there isn't a wolf at the door".
This captures the current American experience perfectly.
Ah yes, the United States -- Don't get sick or you will have to fight tooth and nail to get your insurance company to pay for necessary medical care. This is a story heard over and over again stateside. If the U.S. was truly the best place in the world to live, this would simply not happen. As a person who has worked in healthcare in the U.S. for over 15 years, I feel this in my bones. I am glad you could get legal help and have the right outcome based on what you paid for. I would love nothing more than to see everyone who comes to the U.S. receive medical care appropriately -- Nobody asks to get sick :(
i'm glad the medical side tries to stay focused on patient care. i've a friend in Mexico where they check ability to pay before any treatment begins. she was bleeding out and they waited until after her card was verified before doing anything. lower costs, maybe. One thing that being married to an RN has taught me, the billing department sends insanely inflated bills which are step 1 in their insurance negotiation. I got a bill for over $600,000, I laughed while still in the hospital bed. bill got negotiated down to $150,000. Even if there is a ginormous bill, you can postpone threatened collections by sending them anything, like $10/month. it will reset their billing escalation cycle. debts more than 7 years old will get written off. if all else fails, bankruptcy isn't all that bad. shuffle assets to trusted family. the amount of money they waste on greedy negotiations far eclipses any actual cost for treatment. don't stress over the bills. stress kills. let some fat lawyer worry about not getting a new car this year.
I dunno - my ex burned all the skin off his hand once, the first question at the emergency room was "how are you paying?" and we waited there 5 hours before they saw him, during which time it got so much worse he ended up needing more treatment & therapy. No we didn't have insurance or money back then. They eventually arranged temporary Medicaid for him as he couldn't work with the hand so burned. Which left us without his income (I had just given birth too) so without much food.
Anyway - this was in the 1990s but I am absolutely sure we had to wait because we could not pay, even though it was an obvious emergency.
some are worse than others. I've noticed going to a prompt care is much faster than going to 'emergency room'. depends a lot on location and how busy they are that day. i haven't been seen w/o insurance since 70s when i broke my hand in a fight. doubt they ever got paid for that cast.
Not germane. Zurich Insurance Group is not a USian medical insurance company.
I am well aware of that. This couple's experience was in parallel to what occurs all the time with people who have insurance in the U.S.
Just a stark reminder that all insurance, no matter where you get it from and what country it originates in, is 100% a scam.
That's just blatantly false. I'm all for hating companies that gouge people to make money, but insurance isn't inherently a scam. Insurance, when implemented properly, is paying a low regular premium to offset a risk you can't afford should it hit. I've insured my house against burning down, because I can afford to pay a small amount once a month while a fire (while unlikely) would bankrupt me. Most likely, I'll lose money in the long run by paying for that insurance, but that's not the point. The point is that I can afford to lose money over a 30-50 year period, but I cannot afford to lose my house at any single point during the next 30-50 years.
It’s a nice ideal. Insurance can in theory help smooth out whatever life throws at you. But in the modern world, their incentives are to not
i'll bet you and all your neighbors 100/mo, your house won't burn down this month. send payments on time or else. Meanwhile, i lend you your money to pay for your mortgage with interest. have some more Kool-Aid.
Why would I take that when I already have a running bet with my insurance company where I only pay ≈ 20 USD / month?
The whole point here is that I can afford 20 USD/month indefinitely. However, having my house burn down at any point would be absolutely detrimental to my personal economy, to the point of bankrupting me and likely preventing me from being able to afford a new house in the foreseeable future. I'm well aware that in purely economic terms I'm taking a losing bet. The point is that the consequences should the bet strike home are so large that I can't afford not to take it.
Of course, you could argue that I would be better off saving that money and being "my own insurance". You would be right, except for the fact that the house burning down is just as likely tomorrow as in 20 years. If I had enough cash to insure myself, I obviously wouldn't need to take this losing bet, but I don't.
big insurers have millions of your neighbors paying 20/month. all i know is, 'the house always wins'. they are swimming in cash. my dad used to sell car insurance. when cards became mandatory, he had an influx of 'card buyers'. pay one month and get a card. stop paying. because they bet the odds of getting fined for no card were a lot better than odds of getting in a wreck. house wins, sells you 'uninsured motorist' coverage. people gamble on many things. insurance is good when you win. they lose when you win so deny, depose ... I don't know the answer. just try to hedge bets and look for ways to break even for all us non-greedy shmoes. i don't like most insurance co.'s greed. have insurance as required and savings also. i'd never pay for extended warranty on something under $10k. that's some easy bets for them.
I agree that the house is winning here (as always) and I also hate companies that squeeze us regular people for cash at every opportunity as much as the next person.
My point is that I don't really see buying e.g. house insurance as a gamble as much as I see it as paying a monthly fee for the peace of mind it gives me to know that I won't be financially ruined by a house fire or a burglary. It's not about making money in the long term for me, it's about mitigating the consequences of highly unlikely but absolutely devastating events.
have insurance with allstate because it's cheaper rate. hail damaged the entire neighborhood, 20 houses on two separate days. every other house on my street got 2 new roofs a month before allstate quit dragging their feet and released funds to do mine once. i paid my nephew extra to make it a metal roof and made allstate give me a discount. pay for itself and last long after i'm dead. peace of mind until you have to jump through hoops to make them do what you paid for.
Yes, it's a for profit business that makes it's profit off of trying to have the most accurate odds they can. They charge you slightly more than they expect to lose on you (the house edge) and then they're betting on every roll of the dice. That's exactly how casinos earn money (though casinos try to compete on experience and payout, while insurance competes on price and payout).
The difference is that the casino is attempting to take advantage of your greed and wants you to stay there and bet everything you have. Meanwhile the insurer is selling relief from fear of financial ruin and is asking you to make scheduled bets that you want to lose every month. American health insurance has massive issues and should be replaced with something akin to the NHS before it was defunded, but nobody is losing their shirt buying homeowners insurance unless the area they live in is now being pummeled by the climate crisis like southern California or the gulf of Mexico.
Would government run insurance be better? Yeah probably. But in the era before modern insurance a major part of the draw of fraternal organizations was that they served that role.
Yeah give me that line again after your house actually has burned down and you have to fight tooth and nail to get any money from the insurance company that you've been paying to for the last X number of years.
You are aware that the whole basis for my original comment (and follow-up) was that insurance isn't inherently a scam, right? Any transaction can be turned into a scam if you refuse to hold up your end of the deal, but that doesn't make the concept of transactions a scam in itself.
My impression is that US insurance companies are particularly bad about not paying up, and thereby scamming people. Luckily, I don't live in the US, and don't have any historical precedent that gives me reason to doubt my insurance company would pay up. The problem with insurance (and a lot of other things) in the US is a system that heavily incentivises squeezing consumers at every turn. The problem is not that insurance is an inherently a scam.
I don't think anyone was sick here.
So, your perspective is that pregnant people who have life-threatening medical conditions arising from their pregnancy through no fault of their own should have to pay out-of-pocket? Additionally, in it sounds like you feel that premature births due to life-threatening medical issues that the mother is suffering from and subsequent aftercare for the mother and premature infant should also be paid for out of pocket?
Insurance company trying to evade one job it is supposed to do

You get hired to help out a business in a emergency situation. You do nothing and get paid month after month. A couple years go by and finally the phone rings.
Hey man, we really need you right now! Come on in!
"Claim denied, I will see you in court."
insurance
"But what about helping our people Bob!?"
Not trying to victim blame but do not go to America.
They're Brits
I don't see how the advice doesn't apply. Do not go to U.S.A
Evwn Canadians should recons8der a US visit
Maybe your scummy government should've reconsidered their complicity with the US regime a long time ago.
Their virtue signalling because the big bully you were always friends with and help in their scumbaggery is now temporary bothering you.
hypocrites
It means Brits are the closest to the US with Canadians.
They love the banana republic.
Despite the temporary spat they will be back aiding them in their imperialist looting and mass murder
That sucks... Born in the US....

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