Unaffordable Care

The Nice United Hospital has in the previous year incurred bed debts totalling 3 million dollars arising from treatment provided to inadequately insured foreigners, the majority of whom were emergency admissions. Consultants have been reminded to consider carefully the patient’s ability to pay the fees before embarking on especially for non-emergency treatment and if deemed unable to pay, patients are to be directed back to their country as soon as travel becomes safe for the patient.

Tourist Mr. Nikon from a nearby developing country presents to the Emergency Department with clinical features and ECG findings of a myocardial infarction; he is admitted under Dr Compassion to the Coronary Care Unit and is stable and not hypotensive. The standard protocol is for an angiogram followed if needed by an angioplasty with the understanding that this may precipitate for an emergency coronary bypass surgery. Mr. Nikon cannot afford the estimated bill and declines. Dr Compassion is disturbed and believes that Mr. Nikon is being short-changed. He makes an urgent consult with the Ethics Committee.