Non-profit hospitals an oxymoron

Dr. Kevin Kavanagh
Dr. Kevin Kavanagh

Reports of appalling hospital charges and collection practices describe what I think of as health-care rendition. For years, I have seen some hospitals use aggressive collection practices, even placing liens on homes for non-payment of outrageous medical bills. No one should lose a farm or a home because of a catastrophic illness.

When this happens it can be very bad PR for a hospital. However, according to the St. Louis Post Dispatch, at least one non-profit appears to have come up with a solution by adapting the hard-nosed tactic of rendition, which governments have used to outsource torture. Just sell part of your health-care services to a for-profit company, which then sells the bills owed to an aggressive collection company. The collection company owns the debt and files the lawsuits. The other parties can then wash their hands and possibly their consciences.

All of this is fueling the assertion that the Affordable Care Act, aka Obamacare, is anything but affordable. For those on government insurance such as Medicaid, the ACA has been a godsend. In Kentucky, over 400,000 have been added to Medicaid rolls and the federal government will pick up at least 90 percent of the tab. However, the burden on the federal government and federal taxpayers may not be sustainable.

If you have private health insurance, you may not be so lucky. Many have been strapped with unaffordable deductibles and ever-increasing premiums. Recently a friend of mine was seen in an ER for repair of a lacerated hand which required seven stitches. The total bill came to $7,000, and he had to pay $4,000 to meet his deductible. However, if he did not have insurance the bill would have been astronomical.

Even in economically-challenged Kentucky, we have some of the largest outliers on hospital charges and profits. Norton Healthcare System was again near the top of the most profitable non-profits, with over $200 million in net income. “Non-profit hospital” is turning into a widely recognized oxymoron. The asking price for services from some hospitals is out the roof. Last year, the Washington Post reported that Paul B. Hall Regional Medical Center in Paintsville, one of the poorest areas in the nation, was charging the uninsured an average of 10 times the hospital’s cost; this markup was the fourth highest in the nation. I’m sure they will point out that no one pays the asking price. But then why not avoid the bad press by billing reasonable charges in the first place.

Many hospitals offer discounts if the bill is promptly paid, but at these markups even a reduction of 25 percent to 50 percent is still outrageously high. All of this should send a chill down the spine of those who want to repeal Obamacare and throw Kentuckians off the protection of their insurance.

So what can a consumer can do?

▪ Stay healthy.

▪ Get health insurance any way you can. If you think charges are high with your insurance, wait until you see them without insurance.

▪ If it’s not an emergency, do price comparisons. Prices can vary twofold or more, even for the insured. Remember “your doctor” is probably a hospital employee and may soon join the oxymoron ranks of “non-profit hospital.”

▪ Always obtain a second opinion; remember that by some estimates up to half of some surgeries and tests are over-utilized (politically correct term for unnecessary).

▪ Before you buy an insurance policy, check to make sure your provider is in network.

It is becoming obvious that we need to change the system; this private-public partnership is not working. Either adopt socialized medicine, or the government should get out of health care and restore a truly competitive market. The latter will not be an easy task, since similar to Wall Street, these corporations are becoming too big to fail and too big to regulate. Which course is taken may largely depend upon the results of the fall elections.

Dr. Kevin Kavanagh of Somerset is board chairman of Health Watch USA.