united-states medical
Who pays medical costs for a John Doe who dies in the hospital?
<p>Say that a John Doe case (i.e. someone whose identity is unknown and the patient can't tell them) comes into the hospital and collapses, becoming incapacitated. They receive treatment yet ultimately die. </p>

<p>As the hospital staff doesn't know the identity of the John Doe, they can't tell if they have insurance to pay for the coverage, nor do they have any known next of kin. So who is ultimately responsible for their medical costs?</p>

<p>This question was inspired by the 2016 <em>Doctor Strange</em> movie where Strange brings the Ancient One into the hospital yet she dies, then Strange leaves without identifying her.</p>

<p>In the United States, Medicare and Medicaid pays for indigent patients in hospitals, via <a href="https://www.medicaid.gov/medicaid/financing-and-reimbursement/dsh/index.html" rel="nofollow noreferrer">Disproportionate Share Hospital</a> programs.  This is not a direct reimbursement but a program based on certain qualifications and the ratios of indigent patient days to normal patient days in periods.  </p>

<p>Medicare <a href="https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Disproportionate_Share_Hospital.pdf" rel="nofollow noreferrer">link</a></p>

<p>From the legal perspective, Doe has incurred a debt which would be paid from his estate. But in this case, we don't know who he is, so we can't "find" his estate. Suppose that in reality he is billionaire Bill Smith, who disappears without a trace (he's actually dead and buried in Potter's Field). His family starts the process to have him declared legally dead, and eventually they divide up the estate. Meantime, back at the hospital, there is an unpaid bill, which the hospital writes off as a loss: nobody pays the bill. Likewise the taxi driver who didn't get paid.</p>

<p>In brief, the dead person or, more precisely, their estate. If the estate is bankrupt (in this case because it has no identifiable assets) then the hospital writes off their losses just like every other creditor.</p>
