Growing number of unpaid medical bills at Metro Vancouver hospitals

Metro Vancouver hospitals are facing an increase in non-residents receiving emergency care and skipping out on the bill, CTV News has learned.

The three B.C. health authorities that operate hospitals in the Lower Mainland have observed a growing number of unpaid hospital bills. In the 2018/19 fiscal year, Providence, Fraser, and Vancouver Coastal Health had $22.2 million outstanding, and in 2022-23 that had ballooned to $36.3 million.

The three B.C. health authorities that operate hospitals in the Lower Mainland have observed a growing number of unpaid hospital bills.

About one third of the invoices issued to “non-residents of Canada” went unpaid across the region; the agencies said they do not keep track of country of origin nor the procedures required.

“They’re going up consistent with population increases and we do everything we can to avoid it, obviously,” said health minister, Adrian Dix, in a one-on-one interview with CTV News.

He emphasized while hospital staff always attempt pre-payment, in medical emergencies that’s not always possible and that given the limited collections options, “we’re not going to be able to totally eliminate that, I think people understand that.”

Until they’re considered “unrecoverable”, the rollover carrying costs of those unpaid bills can be considerable. Fraser Health went from $33 million (in 2018/19 fiscal) to $43 million (2022/23) in its accounts receivable balance, while Providence went from $23 million to $42 million in the same time period.

No one denied care

Dix echoed the health authorities’ statements that no patient would be denied care, particularly emergency medical care, with Providence Health Care stressing, “No one is denied care, and we are proud of that approach. We take this approach seriously.”

In Fraser Health, which has seen a surge compared to pre-pandemic levels, the health authority says that’s “partially attributed to a rise in immigration and the resurgence of travel after years of restrictions.” All health authorities say they provide options for payment and try to work with the patients to find a resolution.

Vancouver Coastal Health was the only health authority of the three to show a decrease in bad debt since before the pandemic began, but is still posting the highest figure with nearly $18 million outstanding in 2022/23.

“VCH will work with people with unpaid hospital bills and their insurance companies to ensure payments, with debt collection agencies and/or court proceedings as a final resort,” wrote a spokesperson. “In some cases, VCH may enter into payment plans with patients to recover the debt owed.”

That health authority includes most of the region’s tourist hotspots and Vancouver General Hospital, the largest in the province. Providence Health oversees just two acute care facilities hospitals, Mount Saint Joseph and St. Paul’s Hospital. The latter is in downtown Vancouver and is the closest to the cruise ship terminal.

Treatment is pricey

Dix pointed out that while people should have travel insurance, that’s not always the case and can lead to hefty bills.

A heart attack, for example, that requires cardiac catheterization and three or four days in intensive care, could easily cost $50,000 for someone without health insurance.

Canadians with medical emergencies in B.C. don’t have to pay since the provinces have mutual compensation agreements.

“Our collections are generally very thoughtful and work with people to pay their debts,” Dix said. “We have to be open, when people come here, to provide particularly emergency medical care just like if Canadians go down to a Seahawks game break a leg, they’d expect care down there. And occasionally, I’m sure Canadians leave debts behind as well.”