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