Mixed Reactions Over New Am. Samoa Hospital Fee Increases

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Even with higher rates, service at LBJ reportedly slow

By Joyetter Feagaimaalii-Luamanu

PAGO PAGO, American Samoa (The Samoa News, July 3, 2012) – Far from the public outcry for the previous hike in fees that led to their being rescinded, American Samoa’s LBJ hospital’s new rates quietly went into effect yesterday at 8 a.m., and were met with a mixed response from visitors, with a telling difference in reactions from residents versus non-residents.

For non-residents, rate hikes are much higher in certain areas. For example, outpatient clinic visits are $20 which is "due at time of service" and $85 is the "balance due later."

For an Emergency Department visit, it’s $30 "due at time of service" and $100 is the "balance due later."

Visits to the Medical, Surgical, OB/GYN and Mental Health units are $50 "due at time of service" and $695 is the "balance due later."

Samoa News spoke to a non-resident Samoan man who went in to see the doctor at the Emergency Room around 9 a.m. for an injury to his arm. He said he was surprised to hear about the new fee.

"$30 is just too much for me, I have three girls who are in school and given that our hours are cut back from work, this is another burden" he said.

The man said it will take a long time before he and his family will be considered legal residents in the territory because they only moved here four years ago. "We came here to seek a future for my three children, but then, all these fees charged to non-residents are just too much."

After speaking with Samoa News, the man left the hospital saying he would rather get herbs to put on his arm than spend $30 to see the doctor, because it’s not just seeing the doctor, it’s also the medication that may be prescribed for him. (Prescription prices remain the same, at $10 each prescription for both residents and non-residents.)

A Samoan couple inside the Emergency Room said they were lucky — they got to the hospital before 8 a.m. so they paid only $10. However the man said it’s disappointing that even with the new fee hikes, the service is still slow.

Samoa News met with up with two foreign fishermen who said they don’t care how much the fee is — they are not paying for it — their agent pays all costs if they need to see a doctor.

One of the cashiers told Samoa News that members of the public who went to see the doctor at the Emergency Room were "pretty much okay with the fees."

A security guard told Samoa News that not many people have complained to the cashiers about the fee hike. "I guess the public knew the fees would go up today (Monday)."

A pregnant woman, Nadia Leo said that every visit to see the doctor is $20 if you are not on the trimester program. "I think if I get pregnant again I’ll make sure to sign up during my first trimester so I can be eligible for this program," she said. (The LBJ program qualifies pregnant women, who register during their first trimester, for free prenatal care.)

Malie Finau of Nu’uuli said these new fees are more acceptable than the $50 fees that were implemented before. "Despite the increase from $10 to $20, which is a little bit high, it’s way better than the $50 fee, so I won’t complain. I’ll just thank the LBJ management that the fees are something I can live with," she told Samoa News.

In general — for residents—most Outpatient Clinic visit fees will increase from $10 to $20; while Emergency Department visit fees will increase from the $10 (Day) and $20 (Night) to $30 — anytime.

Outpatient Clinic visits include Dental, ENT, Family Medicine, Family Planning, Mental Health, OB/GYN, Ophthalmology and surgery.

Most ambulance service — provided by the Emergency Medical Service (EMS) — will be $20 per trip, plus mileage, while Advanced Life Support (which is very rare) will be $40 per trip, plus mileage. According to the LBJ fee schedule, ambulance mileage is $3 per transport mile.

Medical, Surgical, OB/GYN and Mental Health units are $50 per day while it’s $30 per day for Pediatric, Nursery or Neonatal ICU Nursing units and $100 per day for Intensive Care Unit, according to the fee schedule.

LBJ says that prescription fees are unchanged; Most Adult Inpatient Daily Fees are unchanged; Ultrasound, CT Scan and Fluoroscopy Study Fees have decreased; and Mammography Fees are unchanged.

(It should be noted that the Mammogram machine was reported as broken, during the LBJ public hearing for the fee hikes, two weeks ago.)

LBJ CEO Mike Gerstenberger told Samoa News earlier that "The mission of the LBJ Tropical Medical Center is to provide care, not to deny care. If anyone feels they cannot afford these fees, they are encouraged to contact our Collections Department and inquire about the Sliding Scale Discount Program," he said.

"The Hospital also continues to offer the Prenatal Clinic Discount for expectant families and a daily ceiling on fees for pediatric patients," he said, adding that new weekly fee ceilings for Dialysis and Outpatient Rehabilitation patients will also be implemented on July 2.

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