I read an article in BusinessWeek Magazine about how hospitals are now putting an even bigger pinch on people without insurance. When the patients can’t pay, some healthcare providers are “requiring” the patients to fill out a credit application for a “CareCredit” card. Patients are given the impression that they can just pay a little at a time. If the patients don’t pay a substantial amount every month, the interest rate on what is owed jumps to 26.99%! Over the course of 4 years, these poor people end up owing more than double the initial charges.
Then, if the patients don’t pay, then the 600 pound gorillas in the credit industry, such as GE, US Bancorp, Capital One, and Citibank use heavy-handed tactics to collect full price for the medical services in addition to the hefty interest rates. A .pdf file of the article is here if the above link goes dead.
John Q. Public is getting squeezed.
A small news blurb just out from United Press International states that 20 percent of US adults cannot afford to pay for needed healthcare.
Girlvet recently put up a thought provoking post about how hard of a time self-pay patients have paying for health care.
One of the things that really upsets me about medical care is the variability and secrecy of hospital charges. A hospital might charge an arm and a leg for a procedure, but most of the time the patient never knows what the procedure costs until after they have received the bill. Compare this to going to the supermarket, buying some cereal, a couple cases of soda, some fresh fruit and a jar of peanut butter, getting home and eating everything, then receiving a bill for $500 in the mail.
Market forces cannot work if there is no way to compare charges.
It gets worse. If you get a bill and try to compare charges, hospitals are notorious for listing a bunch of gobbledygook and indecipherable charges. See this MSN article (or in .pdf). Ninety dollars for a 70-cent I.V.? One hundred twenty nine dollars for a “mucous recovery system” that ends up being a box of Kleenex? Patients are going bankrupt and being sued over charges like this?
A friend of mine brought me a bill that her father received for electrophysiologic heart testing at a regional teaching hospital. The procedure lasted a few hours and her dad was out of the hospital in 6 hours. Now I understand that this is a specialized area, and I realize the the equipment is probably quite expensive. But … the total hospital bill was almost $32,000. That didn’t include the physician charges.
MRI machines are more than $1 million, but an average MRI costs about $1500 to $2000 (my estimate). How does EP testing get to $23,493? Notice how the charges are just lumped into “Cardiology” and “Med-Sur Supply”? What are those charges for?
Want To Fight Back?
- Ask for an itemized bill in writing. Fax the request to the hospital so you have proof that the hospital received your request.
- If you didn’t receive something, make the hospital take it off your bill.
- Don’t pay for any charges that you don’t understand and that the hospital cannot specifically explain to you.
- If you don’t have insurance, ask the hospital about whether you are eligible for charity care. Most religious-based hospitals must provide a certain amount of charity care and most non-profit hospitals must provide charity care to maintain their non-profit status.
- If you don’t qualify for charity care, ask the hospital about a discount for paying cash. If the hospital has to send something out to a collection agency, they have to pay the collection agency 20 to 30% of the amount collected. Ask for a discount of that much if you pay cash.
- Don’t be afraid to go to court. The hospital has to prove that their charges are reasonable in order to collect. If a court finds out that the hospital is charging $129 for a box of Kleenex, chances are pretty good that the court will reduce or eliminate the charges.
I found a web site where you can compare your hospital with others in your state to determine how much your hospital bills compared to the national average: http://www.hospitalvictims.org/ (Disclaimer: No affiliation with the group. Don’t know anything about them. Just thought the database they provide is a neat idea)
A list of payments that Medicare makes for certain conditions is here. If a hospital is charging you 10 times more than the amount they accept from Medicare, how can they claim that what they are charging you is “reasonable”? Show the judge a copy of the payments Medicare makes (and that the hospital accepts) for the same condition.
In addition, www.statehealthfacts.org gives a wealth of data on demographics, costs, and payments.