St. Luke's International Hospital in Tokyo. The health ministry says there has been an increase in cases where foreign tourists have not paid their medical expenses while in Japan. Photo: WIKIPEDIA
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Gov't to survey unpaid medical bills by foreign tourists

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How is it that hospitals are treating people without a means of payment?

It is up to hospitals to check this at the time if patient registration.

And don't most tourists to Japan carry credit cards?

And nowhere in the article does it state the amount owed by foreigners to hospitals in Japan

I would guess that it is a lot less than unpaid bills by Japanese-maybe that should be investigated?

1 ( +17 / -16 )

The average amount of unpaid medical bills, including those of Japanese patients, stood at 50.18 million yen ($446,000) per hospital at the end of fiscal 2014, up 15.7 percent from the year before, according to a survey by the ministry.

Not funny at all....neatly plugged in at the end of the "blame the gaijin" game, the facts come out.

"Including Japanese patients"....how much does anyone want to bet that the overwhelming majority of the unpaid bills are from the Japanese side of the house and NOT the "damn foreigners"?

20 ( +33 / -13 )

While I agree that the amount of money owed by foreigners is much less than is being reported as they are combining both Japanese nationals and foreigners, "Kurisupisu", do you recommend that hospitals turn away patients if they cannot verify if they have insurance. That is starting to sound a lot like what Donald Trump wants to do in the US. Of course hospitals cannot be giving their services away for free, but I feel they must err on the side of humanity and treat patients first, worry about collecting money second.

17 ( +19 / -2 )

This a problem in most modern countries the best idea would be to have Customs / Immigration check visitors on arrival to ensure they have travel / medical insurance if not they then have the choice to purchase it immediately or face being sent back on the next available flight.

-2 ( +9 / -11 )

First off, the money, while not insignificant, doesn't sound like a large percentage of hospital revenues. And as mentioned, who can determine what the Japanese unpaid bills are from the article? Why not separate those numbers for more accuracy?

11 ( +13 / -2 )

Kurisupisu", do you recommend that hospitals turn away patients if they cannot verify if they have insurance.

@MarkX..

Did you know that Japanese hospitals often turn away patients in need of emergency care? Did you know that there are hospitals here that will not see you even if you keeled over with a heart attack at their front door, they would call an ambulance to take you somewhere else?

Private hospitals can turn away patients, public can not, and the article here is lacking on concrete information and once again Kyodo is out to make the foreigners look like the problem.

About 30 percent of hospitals in Osaka that provided medical care and treatment to foreign tourists said in a government survey last year that they had not received payments in some cases.

Example here; plenty of missing information, and a blanket assumption that 1/3 of the hospitals did not receive payment in "some cases". How many? How much? Even if it's one,

According to the tourism agency, roughly 30 percent of foreigners visit Japan without travel insurance covering medical costs.

Where is the evidence to back this claim up? Anyone can pull a number out of a hat, but there is no real way of knowing the actual percentage either.

14 ( +16 / -2 )

Not funny at all....neatly plugged in at the end of the "blame the gaijin" game, the facts come out.

The usual baseless paranoia aside, once the tourists leave it would be far more difficult to get paid. For the Japanese non payers I would think there is already system in place to collect and one is needed for tourists now, that's it. Its common sense.

3 ( +8 / -5 )

Yes, Yubaru, I know that you can get turned away, and have read with horror the stories of children left to die, as the ambulance tried in vain to find a hospital that would accept them. Up here in Tokoku, it happens more than you think. But I still don't agree with the policy, and hope that out of some xenophobic fear that hospitals will start turning away any foreigner on the off chance they might not have insurance, that is my concern.

9 ( +9 / -0 )

Make insurance compulsory for tourists.

Of course, this doesn't address the bigger issue of money owed by Japanese patients. Then again, many people can't afford the bills, many don't even have insurance.

-6 ( +2 / -8 )

As to unpaid medical bills, It seems that they can chase Japanese to pay it up somehow but can never chase foreigners overseas.

-6 ( +3 / -9 )

30% seems like a very high number and I certainly doubt that claim.

As Yubaru pointed out, they are trying to lump foreigners in with the Japanese who haven't paid at the end.

Not sure why people haven't paid. Don't they make you pay before being released? If not, perhaps Japan needs to change the system. Some places don't even allow credit cards so that should be a huge change made.

7 ( +8 / -1 )

About 30 percent of hospitals in Osaka that provided medical care and treatment to foreign tourists said in a government survey last year that they had not received payments in some cases.

tmarieToday 09:32 am JST

30% seems like a very high number and I certainly doubt that claim.

30% of the hospital which received foreigners said that they haven't received payment in some cases.

Which basically doesn't mean anything.

The foreigner thing, from the content of this article, seems to me to be totally unfounded.

12 ( +14 / -2 )

kurisupisuToday  08:14 am JST

"And don't most tourists to Japan carry credit cards?"

I don't know, do you know of a source of statics for that?

"And nowhere in the article does it state the amount owed by foreigners to hospitals in Japan"

Gee, maybe that is why they are going to do a survey, to find out!

"I would guess that it is a lot less than unpaid bills by Japanese-maybe that should be investigated?"

Why are you assuming that is something not investigated on a regular basis? Read the last paragraph of the article again. There's some big clues right there. And it would be no surprise if foreigners owed less as the vast majority of patients at hospitals in Japan are Japanese.

And how in the world are readers getting the idea that the government is out to blame foreigners for the overall problem? Do you seriously think the government has or will ignore the issue regarding the Japanese who don't pay? It is a fact that SOME foreigners (tourists and otherwise) use the medical facilities without paying (I happened to witness such a case just last week while sheparding a family member through a hospital visit). Why shouldn't the government investigate the details and look for ways to prevent that? Or do you just want to let the get treated and run bunch off the hook and use our taxes to cover it all?

-5 ( +2 / -7 )

Luckily I hold in reserve at least ¥50,000 when I travel to Japan for emergencies. While I still carry credit cards with me, it's easier to deal with cash. May last year I had to visit a Tokyo hospital for insect bites which became infected. It came out to ¥35,000, so I was able to pay it in full right there and then.

1 ( +3 / -2 )

Luddite.

Wrong everyone needs to have medical(company, private or government) by law.

0 ( +3 / -3 )

Yubaru,

"Did you know that Japanese hospitals often turn away patients in need of emergency care?"

For lack of ability to pay? Of is it more often for lack of available beds, specialized staff or facilities, etc? I think this is indeed a problem but it's a separate issue from the subject of this article.

2 ( +4 / -2 )

There is a very, very simple solution to this problem. Before the answer arrives, consider the taxes to fly to any foreign country which are hidden in the cost of a ticket. One common tax is the airport landing and take off fee. A plane from any foreign country must pay to land at Narita, Haneda, Osaka, Nagoya, and other airports where direct flights from a foreign country are allowed to land/exit. The passenger looks at the price of the ticket, but does not investigate all the cost. There is absolutely no reason the airlines cannot be required to add the cost of travel medical/cancellation insurance to the cost of the reservation. An example is the cost for a USA citizen to go to the hospital for a gall bladder problem. The removal and hospital stay was paid 100% by the travel insurance. It is not too late before the Olympics start this process. Of course, some travelers will complain, but the cost of the insurance will probably go DOWN because everyone coming into Japan (or any other country) will eliminate the problem. More use equals lower prices and competition.

-5 ( +1 / -6 )

Wrong everyone needs to have medical(company, private or government) by law.

It's naive to think that "everyone" has insurance just because it's a law. Do you have ANY idea what the costs for insurance are here? Sure people can get assistance, but the charges are based upon your previous year's income and if you have no income THIS year but did last year, it can cost A LOT!

I was out of work, had no insurance, went to apply for it, and got told I had to pay close to 300,000 yen for insurance for the year, I had no income, needed insurance, but the people at the town office were ZERO help. I asked, "What am I supposed to do?" they just shrugged their shoulders and told me I had to pay.

What do you think I did?

For lack of ability to pay? Of is it more often for lack of available beds, specialized staff or facilities, etc? I think this is indeed a problem but it's a separate issue from the subject of this article.

I never said that, I was replying to a different post and using that example as some hospitals will refuse care, and not just based upon ability to pay or not.

Reread the thread, and following comments.

3 ( +4 / -1 )

This unfortunately is a worldwide trend and many health care systems have been forced to write off millions in unpaid medical bills from foreign tourists.

In 'generous' western Europe, Oz, Japan and a few more, hospitals/docs won't turn their back on ppl who NEED treatment (which is a good thing). They're health professionals not debt collectors.

I think most tourists do the right thing but you'll always have a small % who take advantage of the system.

0 ( +2 / -2 )

Japanese hospitals and dentists always refuse my offer to pay by credit card. Cash only, they say. Gimme a break, this is the 21st century. At my Bangkok hospital and dentist, credit cards are de rigeur

The Japanese hospitals themselves are largely to blame for this problem.

-3 ( +8 / -11 )

An idea on the cost? Yes, one day to 6 months is about $160. Consult the airlines by going through the booking process up to final payment. Then, close the site. Japan is already experiencing a tremendous increase in tourism, so the Olympics will be bring even more people. In addition, the Olympics has to provide emergency services at EVERY venue. If the Japan taxpayers are willing to absorb the medical costs just to improve the local economy, then, they cannot complain. In case there is any USA citizen on Medicare reading this post, he/she needs to know that Medicare pay ZERO for medical and pharmacy products in any foreign country.

-1 ( +0 / -1 )

Yubaru,

"I never said that, I was replying to a different post and using that example as some hospitals will refuse care, and not just based upon ability to pay or not. 

Reread the thread, and following comments."

I did read the thread and understood you were replying to another comment. My point (which I made because some people seem to get a lot of things all muddled together) is that the issue of being turned away and not getting treated isn't necessarily related to the issue of getting treatment and not paying for it. (Although an excess of the latter could eventually lead to the former.)

I sympathize with your (former I think) problem of needing to go on the national health insurance but not having the money to do so. A family member in a similar boat was able to work out a very very long term low monthly payment plan. But it took many stressful visits to city hall to get to that point. There is that hellish place between qualifying for welfare and being able to pay rent and utilities, buy food, AND pay insurance and pension payments.

3 ( +3 / -0 )

I can't speak for the gaijin tourists, but we (like many here) have Japanese National insurance, as I'm sure most Japanese patients do. Prior to treatment or admittance, you just show that card. You're not told how much you have to pay out of pocket until afterward. I've sat in waiting areas near billing desks on a couple of occasions, and I've heard people (usually older) tell them they couldn't pay.

4 ( +4 / -0 )

Luckily I hold in reserve at least ¥50,000 when I travel to Japan for emergencies.

JDigsJ,

That is a good idea, but for anything serious you WILL fall far short, if you didn't take out extra insurance before you left for Japan you should look into it, its likely FAR cheaper than Y50,000 & will cover you for much more.

When I travel I always grab some, my wife thinks of it like a lottery ticket, if I get killed or die overseas she WINS the lottery!

4 ( +4 / -0 )

I agree with other posters, I'm sure more Japanese are skipping the bill than foreigners by percentages. They should be tackling the problem not labeling the people.

1 ( +4 / -3 )

Hospital bills can be paid by credit card at most places

http://www.h.u-tokyo.ac.jp/english/international-patients/medical-payment/

3 ( +4 / -1 )

I usually take out health insurance when travelling abroad now, ESPECIALLY USA. Thankfully, I've never had to use it, but better to be safe than sorry.

3 ( +3 / -0 )

I agree with other posters, I'm sure more Japanese are skipping the bill than foreigners by percentages. They should be tackling the problem not labeling the people.

If the people Japanese/non Japanese are part of the National Health then 70% is paid for by the government so if a patient does not pay the hospital will still be owed the 30% but gets 70%.

If a tourist receives hospital treatment and does not pay then the hospital will lose 100% of the fees. Hospitals need to provide emergency cover even for tourists but otherwise should ask for proof of payment insurance/credit card/cash before giving treatment.

If a Japanese does not pay the 30% they will be sent the bills monthly until they pay up but a tourist just leaves. Some tourists like in the UK come for the treatment and then run.

0 ( +3 / -3 )

Yubaru.

20yrs in Japan gives me a fair idea of the cost. Both me and Wife were on Company (IT specific). Son till age 6 was 100% free.

No insurance means FULL amount in cash. As was said you need to show proof of coverage beforehand, pensioners pay very little and social welfare cover is also 100%.

My City will also cover/reimburse bills that exceed a certain monthly amount.

Good enough methinks.

0 ( +1 / -1 )

Foreign expats need to stop acting the victim whenever they are portrayed in a bad light.

What the hell does being a "foreign expat" have to do with foreign tourists not paying medical bills?

3 ( +7 / -4 )

Japanese hospitals and dentists always refuse my offer to pay by credit card. Cash only, they say. Gimme a break, this is the 21st century. At my Bangkok hospital and dentist, credit cards are de rigeur

The Japanese hospitals themselves are largely to blame for this problem.

It's "de rigueur" if you want to act suave. Maybe you should just stay in BKK then.

3 ( +6 / -3 )

Wrong everyone needs to have medical(company, private or government) by law.

How very naive.

Well yes, the law says being a member of a health insurance scheme is compulsory, but in the real world many people with temporary work or live a hand to mouth existence do not have this insurance. The number of working poor in Japan is increasing. Not everyone is an employee and not everyone has a pukka employer.

4 ( +4 / -0 )

How do they get treatment?

Yubaru.

What was the reason for the 300.000yen? Sounds like a time of non-payment ergo outstanding fees

-2 ( +0 / -2 )

Good. Look at what a joke the UK's NHS has become in this regard!

-3 ( +1 / -4 )

The problem is simply solved by making people without a form of insurance pay up front or by credit.

-1 ( +1 / -2 )

Its also normal to have issues arise when your tourism has gone up suddenly 1000%.

Japan should just simply prepare better on how to interact with international medical tourism.

3 ( +3 / -0 )

For those who want to keep tourist out and send others home, please note that Japan is an island, 70% of California, and it relies on producing products from imported resources such as oil and steel. Require travel insurance so that the anti-tourists won't have to pay for the medical services that the tourist impose on the Japanese economy. If someone came to Japan to get away from people, it is not possible. Flights leave every day for smaller islands.

-1 ( +1 / -2 )

JeffLeeToday  10:56 am JST

"Japanese hospitals and dentists always refuse my offer to pay by credit card. Cash only, they say. Gimme a break, this is the 21st century."

Ard you in a tiny country village with only tiny, old private clinics? The last few years I've spent oodles of time (mostly with elderly family members) in everything from one doctor clinics to city hospitals to a national university hospital plus dentists. I've made payments with credit cards in all of them and when picking up medicines at the local-owned pharmacy too. I do remember a dentist that required a min ¥3,000 bill before they'd take a card.

3 ( +4 / -1 )

Most of the medium to bigger hospitals I know you can pay at an machine (cash or card) just insert your hospital card.

Do that at my mental hospital, same time it also updates reservation , etc on the card.

Of course you can walk out without paying but your details are known to the Hospital thus easy to send a collection agency round.

Tougher if you leave the country.

0 ( +1 / -1 )

You can't blame gaijins for this. Most people actually have travel insurance when they come here but the hospitals don't have the level of English to ring the insurance companies to get the all clear for procedures or chase the money up afterwards. The staff at the hospitals processing the bills can't speak English and don't know how to go about getting the money from an insurance company outside of Japan. Totally an English failure problem.

They need a national database that can deal with all insurance claims nationwide and can deal with international travel insurance.

Although many Japanese can read and write English, not many have the confidence to talk over the phone.

1 ( +4 / -3 )

What was the reason for the 300.000yen? Sounds like a time of non-payment ergo outstanding fees

No, as I wrote, the payments are based upon your previous year's income. I had a decent income that previous year, and then I was out of work, hence the YEARLY charge. I never said a one time charge, and NO it was not for any outstanding fees either, that is your assumption. The previous year I had SHI.

That 300,000 would have been paid in 4 installments, March, June, September and December .

2 ( +3 / -1 )

Yup, that's how the system works here. Tough at times but unemployment pay should cover.

-1 ( +0 / -1 )

I had to help a friend who was sick, took him to the hospital and he had lost his insurance card, once we got him a new one, the city office worker told me to get to the hospital as soon as we could to get the cash back because if you have no insurance you are charged 25% to 50% more than if you are insured.

When my wife was sick, they wanted their money on the 28th no matter what, and after she passed I went to pay the hospital bill and the hospice was included, it was a pretty large bill, plus the last months hospital stay and treatments, so I asked if I could pay what I had on me and pay the rest after the funeral was over, the lady rudely said " Make sure you pay it by the 28th, no extensions!". So I can't see how they let these people go off without showing how and when they are going to pay.

I guess the idea of making people get insurance when coming to Japan, or any country for that matter, is not such a bad idea!

Also, I have never heard of anyone having to pay up front, or anyone being turned away at any hospital.

3 ( +3 / -0 )

Good. Look at what a joke the UK's NHS has become in this regard!

I'd rather the NHS than many other healthcare options out there. But this is Japan and so far; the rates are acceptable. Obviously, not every patient will have the same experience.

2 ( +2 / -0 )

the hospital won't even know the total costs until you are examined and treated so it could be a small problem or a bigger one. You will be treated regardless of your nationality and only when it comes time to pay you will be given the amount due according whether you are part of the National Health (30%) or not (100%). Hospital can't refuse treatment.

0 ( +0 / -0 )

The average amount of unpaid medical bills, including those of Japanese patients

The article doesn't confirm whether majority of the unpaid bills were by tourists or local residents so not sure why people are all pissy about it targetting foreigners. Regardless though as others have pointed out.. locals who have unpaid amounts fall into a less risky bracket given they likely aren't going anywhere. Given how affordable decent medical services here w/ or w/o insurance is I'm supportive of anything that keeps it that way (i.e. identifying issues like this).

-4 ( +0 / -4 )

Olympic coming and Japan expecting more sick tourists?

3 ( +3 / -0 )

How is that possible !!!!

I went 2 times to a hospital/doctor during my stays in Japan. I just had to pay. And the thing was settled.

What kind of tourist were this ... the same who cannot behave, with rude attitude, the ones who flood Asakusa these days?

1 ( +3 / -2 )

In 2015, I came to Tokyo for 6 weeks. I had travel insurance. I then decided to stay longer. By then my travel insurance had run out. NO ONE would insure me, they all thought I was pulling a scam (always top up before it runs out.) I then stayed without insurance. I injured my leg playing football. My girlfriend rang hospitals. The first two refused to take me because I was foreign, one said they didn't take travel insurance. Finally we found one. I was terrified it would cost a fortune but the Dr cost £24 and the useless pain killers £30. Total cost with a bit extra £100. To me, it's a system thing.

0 ( +1 / -1 )

Travelers insurance may help tourists.

1 ( +1 / -0 )

its a difficult topic, hospitals usually have atm,s. but i have been to many hospitals, never refused. the debate should be about clinics and hospitals. medical tourists are a problem. they don't trust their country, so it says something good about japan.

just hope everybody can get better.

2 ( +2 / -0 )

I don't know whether the visitors are intentionally come to Japan for Medical treatment or it was coincident. Also the Hospitals in Australian were millions dollars unpaid medical treatment bills left by foreign visitors every year, mostly visitors from Indian subcontinent, Africa and Middle East. One time, Australian Government was advised for to ask deposit $ 30,000 into Bank when someone has sponsor family members, relatives and friends from high risk country like Indian subcontinent and Middle East as well as Africa. They can withdraw their money if their visitors have not have any debt left in Australia.. I have read some treatment cost as much as $ 50,000 and the patient has left Australia without paying the Hospital bill. Also the host of patient refused to pay the bill and most of hosts were living in Australia with student visa or working permit visa. There’s no way afford to pay the bill left by their visitors.

Most foreign visitor patients have admitted to Hospital within week after they arrived in Australia. They have brought their medical history record with them. Those foreign visitors and their hosts knew the Hospital billing system and they took advantage of generosity and the system.

They have to buy medicines and meals themselves and pay advance for part of operation and other treatment bills once patient was admitted to Hospital in their country. The patients get first class medical treatment and specialist consultation in Australian Hospital. The Australian citizen has to wait for the years for some non-life threatening emergency operation at Hospital but foreign visitors do not need waiting list for their treatment.

It’s very difficult for Hospitals to refuse when patient come to them. Japan and Australia are wealthy developed country and Government should foot the bills as long as the unpaid bills were within the limit. Otherwise, Government can ask some deposit before issue Visa to visitors from high risk countries.

0 ( +0 / -0 )

Mostly these tourists are from Communist China. Some Chinese also set up sham companies in Japan. According to Japanese labor law, employees who have worked three months or more are eligible for 70% reduction in medical and hospital costs. So these companies will "hire" terminally ill but appearance-wise normal people from China, such as those diagnosed to have early-stage cancer, who pay big fees to such companies for the "service" and the phony wage payments they receive during those three months (which fools Japanese authorities).

0 ( +0 / -0 )

I don't know whether the visitors are intentionally come to Japan for Medical treatment or it was coincident. 

One thing not mentioned in all of this is that Abe wants to advertise medical tourism to Japan as well.

0 ( +3 / -3 )

This could back fire badly where Japanese in other countries as Tourists and University students and back packers could be refused medical help and lives will be lost.

-4 ( +0 / -4 )

@Ron

Unlikely to happen in England. The wife got treated at the local clinic last time we were over, and, despite her obvious foreignness, nobody even asked where she was from!

3 ( +3 / -0 )

With all the comments I wonder how it matters for the hospital if the tourist has insurance or not!

He has to pay for the medical service and the hospital is obliged to issue a documents of prove to the insurance company. Then he can apply and collect his money at a later date from the insurer!

I thought it was the only way or I'm wrong?

I always made travel insurance but nowadays rely on the one stipulated in my business credit card...

0 ( +0 / -0 )

This is so easy to fix at point of entry – no travel insurance – no entry unless you buy some there and then.

1 ( +1 / -0 )

If a foreign tourist doesn't have travel insurance, maybe they should be required to set up a deposit account prior to entry. Otherwise no entry, etc. A foreign health leacher hurts the entire health system here for residents as it causes waste and higher costs so is a direct hit against the residents which is unacceptable.

Of course hospitals should never refuse medical help, but if the foreigner cannot cough up then they should be detained and some plan worked out for them to compensate the system before they can flee the country

0 ( +0 / -0 )

30% is a pretty big co-pays.

0 ( +0 / -0 )

@garypen

It's only 30% up to a certain limit. Your income is taken into account, and then there's an absolute maximum for everybody.

0 ( +0 / -0 )

30% is a pretty big co-pays.

It is not that high if you think of how much cheaper the prices are in Japan, and if you go through the hospital they will help you fill out the paperwork to keep the cost at about 80,000 yen per month for your average person for long stays or expensive treatments, the city office is also involved, but it goes rather smoothly!

0 ( +0 / -0 )

When the demand for a treatment goes up the cost is reduced by the government. The 30% paid is a reasonable amount especially if compared to the costs in America.

0 ( +0 / -0 )

The article is about foreign tourists who use Japanese medical facilities in Japan and leave Japan. Not about Japanese who don't pay. So my suggestion is Japanese gov't invite health insurance companies to increase foreign tourists health insurance business. Tourists usually come to Japan with money. If they've insurance from their home country, fine.

-1 ( +0 / -1 )

@Yubaru, You used Japanese medical care. Stop insulting Abe for this problem. Abe did not make you sick.

0 ( +0 / -0 )

Where are most of these people that have not paid their Medical Bills from?

0 ( +0 / -0 )

Charge the airlines that brought them in.

They already have personal and credit card details and have been screened for security purposes.

And offices overseas to recover debts.

It won't happen of course. Instead, like Thailand is considering, everyone will be taxed to spread the costs and have the honest one pay for them.

I'd like to read more details of who and what they are talking about.

Most developed nations have the same problem. The UK has a series of cases of Nigerians going into labour on the flight over and then racking up bills of £500,000 and £350,000 and then demanding a visa to stay.

Tell me they don't know the racket in advance?

A hospital needs to pay its staff, its staff have to pay their bills, why should they work for scammers free?

-1 ( +1 / -2 )

Where are most of these people that have not paid their Medical Bills from?

Japan, for all we know. The article doesn't make clear the percentage of Japanese vs foreigners that aren't paying their medical bills.

If a foreign tourist doesn't have travel insurance, maybe they should be required to set up a deposit account prior to entry. Otherwise no entry, etc.

Sounds like a pain in the butt. That'll never work.

A foreign health leacher hurts the entire health system here for residents as it causes waste and higher costs so is a direct hit against the residents which is unacceptable.

I don't see how this is an issue. If it's emergencies we are talking about, I doubt they are leechers. If not emergencies, then can't the hospital just require they hand over their passport prior to treatment and hold it until they pay up? When I go to a hospital, they hold on to my insurance card so there is no point in me trying to make a getaway.

0 ( +0 / -0 )

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