Wednesday, June 08, 2005

Uncompensated Care Takes $$ Out of YOUR Pocket

An exec of a hospital in Glendale, CA, told me several years ago that a quarter of every patient's hospital bill was administrative costs -- billing, insurance paperwork, accounting, etc. And other quarter was "cost shifting:" bills of those who don't pay are divvied up among those who do. Basically, your medical bills are doubled to cover expenses that have nothing to do with your actual medical needs.

Since we talked, things have only gotten worse. Uncompensated care is so costly that it is bankrupting -- and closing -- hospitals across the country. Others eliminate emergency rooms and trauma care to focus on high-return specialties: cosmetic surgery (which is strictly cash-up-front), heart centers, and other by-referral services for the affluent or insured.

A new study from consumer group Families USA has calculated how much your health insurance premiums have increased to cover the disaster of uncompensated care: $900+ per year for the average family. In five years, that's estimated to rise to $1500. For singles, the added charge is $341, expected to rise to $532 by 2010. No wonder an ever-increasing number of Americans cannot get or cannot afford health insurance.

So who isn't paying their hospital bills? If you are a U.S. citizen who lacks health insurance, the hospital will put you on a payment plan, garnish your wages, even put a lien on your house -- anything to collect so they stay in business for the next patient. If you are genuinely poor and have no assets to attach or wages to garnish, the hospital will help you apply for state Medicaid programs and your state taxes pay the bill.

Permanent legal residents, if they hope for citizenship, had better pay their bills. A "public charge" law is a bar to citizenship. They cough up one way or another.

Illegal aliens, however, are the only people in the U.S. who are entitled to free medical care by law. While hospitals "treat 'em and street 'em" any way possible to prevent getting stuck with the bill, if they need care, they can't get rid of them.

So an illegal alien who was driving without a license and cracked up his car, permanently paralyzing himself, is "bought off" with a year's worth of supplies, hospital bed, wheelchair, medications and all to send him to his illegal-alien brother's home. The hospital trades off a half-million dollar expense to save another million. If illegal aliens refuse to return to their home country for continuing care, there is nothing the hospital can do.

Illegal aliens in hospital emergency rooms include the mother of a four-year-old with a cold who doesn't want to spend (and claims she cannot afford) five bucks for a bottle of cough medicine. The emergency room bill exceeds $250. She shrugs her shoulders and takes a bottle of cold medicine out the door with her. Who pays? You and I.

Miami hospitals report they are inundated with tourists who debark at Miami International Airport and take a taxi to the hospital. They were diagnosed at home with a need for a heart transplant, chemotherapy, whatever, and find it cheaper to fly to the U.S. and get it done at Americans' expense.

Sob stories are legend: "my kid needs a kidney transplant or he'll die," or whatever. They slink over the border with their sick kid (worsening his condition), go to a pro-illegal alien lobbying organization and rev up the PR machine for donations, tea and sympathy. Actually, on a per-capita basis, Mexico performs slightly more kidney transplants than than the U.S. and the cost runs less than half the typical $75,000 U.S. cost. But Americans are naive enough to swallow the tale that this "poor suffering kid's life" cannot be saved unless we let the family rob us blind.

If we do not stop taking care of the rest of the world, we will not be able to take care of ourselves. Meanwhile, thousands of Americans are bankrupted every year by medical bills when half the bill is unrelated to their actual medical needs.

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