| If you've ever felt aghast looking over a hospital | | | | to charge poor and uninsured patients less, but |
| bill -- somehow sure the numbers couldn't possibly | | | | the results have yet to be seen. Some question |
| be right -- you're not the only one. According to a | | | | whether the recommendations are applied at all |
| 2004 study, published by the journal Health | | | | by most of the hospitals, including those in Texas, |
| Affairs, those lacking health insurance are charged | | | | and the fact it's not mandatory is a problem. |
| an average of 2.57 times more by U.S. hospitals | | | | Gerard Anderson, director of the Center for |
| than those with insurance, a discrepancy that has | | | | Hospital Finance and Management at Johns |
| been steadily increasing since 1984. | | | | Hopkins University's School of Public Health -- and |
| Texas is no exception. In fact, residents of Dallas, | | | | study author -- has served as an advisor for |
| Houston, and the rest of the state are more likely | | | | several lawsuits already. He encourages advocacy |
| to be uninsured than the average American, as | | | | groups to move forward with legal action. "The |
| just over 25% of Texans lack coverage. In some | | | | mark-up on hospital care for these individuals, |
| areas of the state, it's closer to one in three, and | | | | especially for those who can afford it least, is |
| that doesn't include those considered underinsured, | | | | unjustifiable," said Anderson. |
| or those insured by government programs. | | | | The highest discrepancy was found in the amount |
| Like many in Texas, a good percentage of | | | | for-profit hospitals charged, versus estimated |
| uninsured Americans are working individuals who | | | | costs by Medicare. This all makes slightly more |
| can generally support themselves and their | | | | sense after learning that, generally, hospitals in the |
| families, but who cannot afford to keep pace with | | | | association determine costs by a list called the |
| the rising cost of healthcare. Health insurance | | | | chargemaster, which is, technically, the same for |
| premiums have increased an average of 15% | | | | everyone. Insurance companies then negotiate |
| over the last five years, more than triple the | | | | with hospitals on behalf of their clients to reduce |
| inflation rate. One-third of companies did not offer | | | | these charges. It is widely believed hospitals, as |
| coverage in 2004, and even when it was offered, | | | | many other businesses would, however, greatly |
| there was no guarantee that employees could | | | | inflate initial costs in anticipation of this negotiation. |
| afford the premiums. | | | | "When a hospital presents a bill that has charges |
| "That's me exactly," said Anne, a 27 year-old city | | | | on it, those charges are the same for everyone. |
| employee in Kansas City, Missouri. "I couldn't | | | | What is different is how much insurers may |
| afford the premium, so I had to get this low-cost, | | | | negotiate in terms of discounts with hospitals," |
| ridiculously low-coverage plan that will basically only | | | | Amber Coyle, AHA policy analyst said. |
| help me if I get in a car wreck." | | | | The American Hospital Association also claims the |
| Employee spending on healthcare increased an | | | | research is inaccurate, that it is out-of-date and |
| average of 143% between 2000 and 2005. It | | | | methodologically flawed. Hospitals needed the U.S. |
| does not seem a coincidence, then, that rates for | | | | Centers for Medicare and Medicaid guidance to |
| the uninsured have also jumped the most since | | | | institute discounts for the uninsured, said AHA, |
| 2000. The problem is further exacerbated by | | | | which did not exist when the study was |
| what has become a cyclical predicament, | | | | conducted. |
| particularly in cities like Dallas and Houston: | | | | The claim is that hospitals were unsure if they |
| uninsured residents of rural areas, where there is | | | | could charge different patients different amounts |
| lower quality care and less access to financial aid | | | | before this guidance, but many advocates |
| programs, travel to the city for their medical | | | | contend it does not take bureaucratic policy to |
| needs, which can then be covered by hospital or | | | | know that charging those who are financially less |
| county programs. This, in turn, drives up the | | | | capable of paying more is simply wrong and |
| average charge of any given service provided by | | | | counterproductive. |
| those hospitals, which contributes to increased | | | | The only issue opposing groups seem to agree on |
| costs for health insurance companies, which then | | | | is that increasing the number of those with |
| raises premiums. | | | | coverage would dramatically deflate the situation. |
| What all this translates into, unfortunately, is even | | | | This could be done by extending government |
| higher bills for those who are barely getting by as | | | | programs, including Medicaid -- which is currently |
| it is if something does happen. | | | | experiencing drastic cuts - and instituting more |
| Sound unfair? Advocacy groups think so too. | | | | affordable private health insurance policies. Either |
| More than 60 class-action lawsuits have been filed | | | | way, until then (or "if then"), keep yourself |
| over the issue. In response, the American Hospital | | | | healthy, whether or not you're insured. |
| Association (AHA) has instituted a voluntary policy | | | | |