Motherhood used to be simpler. You went to the hospital, in most cases, gave birth and that was it. Is it a boy or girl, does it have all its bits, does dad have the obligatory cigars to hand out?
But with the development of reproductive technology a new class of moms is discovering some bottom-line complications that happen not in the delivery room but over in the hospital's finance office.
The National Post reports surrogate mothers in Ontario are being billed for hospital services after giving birth even though they have provincial medicare coverage.
The reason: The babies were being taken out of the country.
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The issue raises a real question about who should be on the hook for costs for delivery of a baby in an international surrogacy arrangement, the Canadian taxpayer or the parties involved?
For example, the Post noted Ontario resident Bethany (her last name was not revealed) was billed $1,400 by her local hospital after giving birth to a baby destined for a couple in Italy. The child was Canadian by virtue of its birth here and Bethany was covered by the provincial medicare plan.
In any other situation, Bethany would not have been out of pocket one dime, Toronto fertility lawyer Michelle Flowerday told the Post.
“These are my clients, so I don’t want to see them in a position where they’re paying hundreds of thousands of dollars," she said. "But then again, when the child’s not going to live here, it’s taxpayers’ dollars. There are two sides of the story.”
In another case, the Post said, a woman gave birth to premature twins for a Spanish couple, who whisked the babies home but skipped out on a $58,000 hospital bill that was left for the surrogate to pay.
“It’s pretty awful to carry babies for a couple and have a C-section and everything and have them just leave you with huge medical bills,” Sally Rhoads-Heinrch, a surrogacy consultant who operates Surrogacy in Canada Online. “It has definitely destroyed some relationships.”
The web site's Frequently Asked Questions page makes passing reference to reimbursement of costs and expenses (paying surrogates is illegal) but doesn't address the issue of hospital charges levied in international surrogacies.
Flowerday told the Post she had to negotiate with a hospital after foreign parents were charged $700,000 to care for a baby carried by a Canadian mother. The bill was cancelled when the newborn stayed in Ontario long enough to qualify as a resident and get medicare coverage, she said.
Some surrogates are simply not revealing they're international surrogates, she added.
Rhoads-Heinrich said in the past Canadian hospitals did not charge for services to surrogates, which along with free pre- and post-natal care helped make Canada a popular choice for foreign parents.
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But that has begun to change as the number of foreign and out-of-province surrogacy arrangements grows, the Post said.
For instance, administrators for Quinte Health Care, which runs four hospitals in the Belleville area east of Toronto, have developed a policy that bills out-of-province parents $388 a day for basic post-natal care. Foreign parents are charged $720 a day, standard fee for foreign patients, the Post reported.