As birth tourism climbs in B.C., health authority files $312,595 lawsuit over one unpaid childbirth bill

Although the overall number of birth tourists is low compared to the total number of births in Canada (see What happened to Kenney’s cracking down on birth tourism? Feds couldn’t do it alone | hilltimes.com), appropriate to ensure that any unpaid bills are collected. “Birth houses” at a minimum need to be regulated if not banned given this is clearly an abuse, even if relatively small, of our immigration and health systems:

Record numbers of  so-called birth tourists, mainly from China, are expected at Richmond Hospital this year. Yet the Vancouver Coastal Health Authority has no plans to deter women from having their babies at the hospital to give them Canadian citizenship, despite suing a woman for nonpayment of $313,000 for her delivery.

The lawsuit filed in April relates to a birth in 2012 that involved complications and kept the lawsuit defendant, Yan Xia, and her infant, in the hospital for an extended time. Xia has not yet filed a statement of defence.

Although the hospital reserves the right to add interest charges of two per cent a month to unpaid bills, a spokeswoman said that is not the plan at this point. If such interest were to be added, the bill would exceed $1 million.

There has been a steady increase in the number of babies born to non-resident mothers at Richmond Hospital, to 384 in 2016-17 from 18 in 2010. Halfway through the 2017-18 fiscal year, there were 189 non-resident births, according to VCH spokeswoman Carrie Stefanson.

While all pregnant women are asked to register well in advance of giving birth so that hospital resources can be planned, there have been no measures taken by the hospital to deter birth tourism, which now accounts for 20 per cent of its deliveries. That is believed to be the highest proportion in the province, if not Canada. B.C. Women’s Hospital discourages birth tourism through various policies and practices. At times, Richmond Hospital has to send local women in labour to other hospitals when it is too busy.

The birth tourism phenomenon is tied to several factors, including Richmond’s demographics, a preponderance of “birth houses” for pregnant Chinese women in the city, the large number of doctors and nurses who speak Cantonese or Mandarin, and an industry fuelled by brokers who charge high fees to make the arrangements for women wanting to have so-called “anchor” babies in Canada.

Stefanson said she believes the Xia case is the only maternity lawsuit over $100,000 so far. Typically, the health authority uses other means to collect unpaid bills.

“VCH has invoiced non-residents for approximately $43 million in (all kinds of medical) services in the past year, and has collected about 80 per cent of that amount,” she said.

In the Xia case, such efforts have been unsuccessful, and with a six-year deadline for legal action approaching, the health authority decided it was time to take that action. Xia’s whereabouts are unknown.

Stefanson said the hospital exists to provide health care and will never deny urgent hospital care to anyone based on their ability to pay or where they are from.

She said the health authority expects foreigners will have travel insurance or some other means of paying. Non-resident pregnant women who go to any hospital in B.C. are expected to pay a deposit of $8,200 for a vaginal birth and $13,300 for a caesarean delivery. If they stay in the hospital for at least a night, there may be additional charges. In the past year, VCH has invoiced non-resident maternity clients $6.2 million, and 82 per cent of that amount has been recovered.

An article posted on the “Hongcouver” blog in the South China Morning Post says Richmond is at the centre of the birth tourism phenomenon. It highlighted one “birth house” called the Baoma Inn and its Instagram account showing photos of smiling expectant or post-delivery Chinese mothers enjoying touristy outings around Vancouver. Also pictured are newborns asleep, next to their new Canadian passports. In addition to pre- and post-partum accommodation, the inn is said to be able to arrange birth certificate and passport services plus getting newborns enrolled in the B.C. Medical Services Plan so they can receive publicly funded health care after they’ve resided in the province for three months.

The Baoma Inn is one of the dozens of so-called birth houses in Richmond. It is not known what birth house the defendant in the VCH case used, or even if she stayed in one.

The South China Morning Post article pointed out that Canada is one of a few countries (including the U.S.) that offers citizenship to babies born in the country, regardless of the nationality of parents. By contrast, in China, nationality is acquired upon birth only if one parent is a Chinese national, similar to policies in Australia and Britain.

David Georgetti, the Mandarin-speaking lawyer retained by VCH to litigate the case, could not be reached for comment.

Source: As birth tourism climbs in B.C., health authority files $312,595 lawsuit over one unpaid childbirth bill

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

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