Facts
According to a RAMQ report published in 2022, there are generally between 1000 and 2000 women who give birth “outside RAMQ” in Quebec hospitals each year. Between 35 and 40%, generally, are asylum seekers, but there are all kinds of possible cases here — tourism, studies, new spouses, etc.
No wonder, then, that there are indeed stories that surface from time to time in the media about pregnant women who have to give birth in Quebec without having access, at least not yet, to public health insurance. Some of these topos talk about refugees who have just arrived, or the newly arrived spouse of a Quebecer, or other cases.
But in most cases, these articles mention the figure of “$20,000 for childbirth”, or something very close to it. How do we arrive at such a bill?
According to the spokesperson for the Quebec University Hospital Michèle Schaffner-Junius, it is the hospitals which must bill patients, but the prices are fixed in advance by a “ministerial circular” — the poetically named 2023-008 Appendix 4 .
This states what hospitals must charge patients from other provinces, which then serves as the basis for calculating the bill for a delivery. The policy actually wants hospitals to start from the “day price for newborns”, then increase it with a “200% surcharge” – so they multiply it by three. In the case of the Quebec University Hospital, this base price is $1,753 per day, which means that migrants and other women who give birth “outside RAMQ” must pay triple that: $5,259/day.
“As a reference, we estimate that women are hospitalized on average two days for this type of intervention,” adds Ms. Schaffner-Junius.
However, this amount does not include medical fees, which generally amount to around $1,000 for a delivery, according to the RAMQ report cited above.
In total, for a hospitalization that would have lasted two days, the bill should therefore be around $11,000 at the Quebec University Hospital. But you should know here that the “basic” rates set by the ministry vary from one establishment to another and that they can reach $2,800 per day in certain Montreal hospitals.
In these places, counting the “surcharge” which triples the bill for uncovered women and medical fees, we reach almost $18,000 for a birth that would require two days in the hospital, and 26 000 $ if the stay extends for an additional day.
The figure of “$20,000 per birth” seems entirely plausible — especially since most of the media are based in Montreal.
(It should be noted here that the RAMQ document suggested in 2022 abolishing the 200% surcharge, but that the recommendation was clearly not followed.)
Now, is it more or less expensive privately? It seems that the price of $20,000 (therefore the upper price range in Quebec) corresponds quite well to the American market. A study published in 2021 in theInternational Journal of Environmental Research and Public Health mentions prices varying between $8,000 and $19,000, in American dollars, for a childbirth, with an average around $13,000 — a figure which is confirmed by other sources.
With the exchange rate, that’s about $20,000 in Canadian money.
Verdict
True, but not everywhere. It is especially in certain hospitals in Montreal, where the fixed costs per day are higher, that the typical bill can approach $20,000. This is a price comparable to what it costs to give birth privately in the United States.
