Hundreds of foreigners have left Bay of Plenty District Health Board to foot costs that could have paid for more than 30 elective surgeries over the past four years.
The money written off by the health board since 2007 totals $160,000 - and the totals being invoiced to non-residents is growing by the year.
The health board has now introduced a new policy, which requires those patients seeking elective surgeries and care in the hospital outpatients department to first prove they are citizens.
Because the Ministry of Health does not give the health board special funding to cover bad debt from non residents, the health board is forced to absorb the costs.
Of the $451,251 invoiced to 181 patients in 2009, $29,533 was never recovered.
Foreign patients cost the health board almost $100,000 in bad debt in 2008, however in the 2010 year to May, approximately $3000 was all that was written off from a total bill of more $715,133.
Rebecca Stevenson, the health board's regional ACC manager, said the move came after growing efforts to tackle the problem over the last five years.
Previously, the health board found itself having to chase up patients who had already received care, and turning to international debt collectors as a last resort.
Ms Stevenson believed the new policy also allowed ineligible patients the time to decide whether they wanted to go ahead with surgery - rather than receive a bill afterward that they may not been expecting.
"If they have to pay, it's important that they know. It's very difficult when it ends up becoming a huge burden on the family."
The cost of treatment at Tauranga Hospital's emergency department ranged between $390 and $920, and just 24 hours in the intensive care unit could sting them for more than $3000.
An assessment cost $1215, the average elective surgery cost approximately $5000, while a non-eligible woman giving birth who required a caesarean section could expect a bill of $6644.
"Some patients can get quite upset when asked to prove their eligibility, but I think in the end they understand why we need to."
The Bay of Plenty was particularly affected by the issue because of the high number of non-residents coming to the region for seasonal work, she said.
In some cases, passengers from visiting cruise ships had been invoiced. "The big message to non residents really is to get health insurance."
Settlement Support NZ Tauranga co-ordinator Carol Andersen believed the health board's new policy was "absolutely necessary".
Over more than four years in her role, she had seen some non-eligible families left with massive amounts to pay, including one mother whose bill totalled more than $60,000.
WHO'S ELIGIBLE
- New Zealand citizens, including people from the Cook Islands, Niue and Tokelau.
- People who hold a New Zealand residence permit and returning residents visa.
- A person who holds a work permit which on its own or together with other permits allows the person to be lawfully in New Zealand for two years or more.
- Anyone born in New Zealand before January 1, 2006.
- A child born in New Zealand on or after January 1, 2006, who parent is an eligible person.
- A child aged under 17 years whose parent is an eligible person, or under 19 years and dependent on a parent who is eligible.
- A person receiving compulsory health services.
Source: Bay of Plenty District Health Board
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