Hospitals Struggle Over Who Can Afford To Pay

Do ‘rich’ people deserve medical charity too?

“For some people making above $100,000, when they get a hospital bill for $100,000, they may not have the ability to pay,” said Gerard Anderson, director of the Center for Hospital Finance & Management at the Johns Hopkins University public health school.

(hat tip: Medical Quack)

Comments

Matthew
I think we should just defer to Hillary Clinton. I’m sure she knows what’s best for all of us and a government run by her would be best at taking care of all of our needs. At least, she seems to think so, so it must be true.
Anonymous
People confuse higher earnings with rich.
The typical $100,000 earner would be expected to have debts in excess of assets (excluding his home a an asset because he has to live somewhere).
‘Rich’ is the state of having sufficient assets that one does not have to work without their present life situation totally collapsing.
That $100,000 earner also missed a few months work (income) while acquiring his medical debt, such that he is now living on the edge. That $100,000 medical bill is two years after tax income; but considering that he has other ongoing expenses, could easily take a decade for the most frugal to pay off.
Without Bill Gates kind of riches, almost no one can afford to get sick.
Anonymous
“Without Bill Gates kind of riches, almost no one can afford to get sick.”
Which is why people are dropping like flies all across this great nation of ours. Why the streets are littered with corpses and near corpses. The sky is falling! The planet is getting hot! Run for the hills!!
Anonymous
Well, one way hospitals help insure that people can’t afford to pay is to use cash pay patients as a subsidy for insured payments and defaulters. This means that I, as a cash customer, pay 3 times what an insurance company pays for the same service. This triple markup helps insure that the bill I receive will be unreasonably high and correspondingly difficult to pay off.
We need insurance reform. Insurers need to pay their fair share for treatment and self-pay patients shouldn’t pay more than insurance companies. It is unreasonable, unfair and unconscionable to try use self-pay patients to subsidize the shortfall caused by low insurance reimbursements.
Anonymous
To the last poster:
The moment you are no longer a cash-poaying patient, you will be screaming at your insurer to lower premiums by negotiating for lower rates. After all, it is a “BIG” insurer, with lots of patients, surely they can negotiate better and get you a lower premium, right?
Or will you volunteer for the policy that agrees NOT to negotiate for lower premiums?
Anonymous
The moment you are no longer a cash-poaying patient, you will be screaming at your insurer to lower premiums by negotiating for lower rates. After all, it is a “BIG” insurer, with lots of patients, surely they can negotiate better and get you a lower premium, right?
Or will you volunteer for the policy that agrees NOT to negotiate for lower premiums?
Well, actually I support the **largest possible insurance pool**, aka universal healthcare. Frankly, being pooled in with everybody, including “sick people” (shudder) could actually increase what I pay (assuming I’d pay higher taxes in lieu of my self-pay and my high-deductable catastrophic policy) but I think it would be better for the US in general. Maybe then patients could be honest with their doctors rather than hiding conditions they think might cause them to be denied health coverage in the future.
Anonymous
Since a free market can not exist in emergency services, given the inability of the consumer to shop, I would be all for the minimally intrusive regulation that a hospital can charge it’s cash customers no more than 120% of what they would collect from their largest non-government insurance provider with whom they contract. That way, the government isn’t setting the price, the hospital still does that when it negotiates it’s contracts, just regulating the premium charged to cash customers. The presumption here is that the hospital is not going to long maintain a non-profitable contract with it’s largest customer as that is a financial impossibility, and therefore must be at least breaking even at those rates.
Lisa
“Well, one way hospitals help insure that people can’t afford to pay is to use cash pay patients as a subsidy for insured payments and defaulters. This means that I, as a cash customer, pay 3 times what an insurance company pays for the same service.”
It’s worse than that where I’m from. The doctor who just analyzed my husband’s echocardiogram billed $760.00. The insurance company paid $79.27, with no co-pay. How can that be?
You can’t really shop around for the best price/value for medical care because how can a non-doctor know what the likely billing code will be?
And given that there is really no way to know what the charge will be, how is it that hospitals and doctors can set completely arbitrary rates and people should be required to pay them? I’ve never understood how this is even legal.
Mike
What are you talking about??? The doctor probably checked “Accept assignment”, so who is getting away with anything??? The doctor gets screwed every-freaking-time! Its the gov’t and insurers who shouldnt be aloowed to do this.. but they do.
Anonymous
Obviously $79 is acceptable to him for the service or he wouldn’t take it, so clearly when he charges 10 times that, he is gouging just because he can.
Anonymous
Once upon a time, you could appeal unreasonable charges to the medical society, but the feds say it is illegal–even though all the medical society could do to enforce it was expell the member which would have no impact on anything but his feelings.
Anonymous
Nobody “deserves” medical charity.
Mike
“Obviously $79 is acceptable to him for the service or he wouldn’t take it, “
I am now convinced that you have no idea what you are talking about. Doctors accept assignment because they are locked into contracts, and the gov’t is just another bad contract. You think I like getting 55 bucks for spending 20 to thrity minutes for a chronic diabetic, whom I like, but cant make much from? So why dont I just opt out of all the plans and have no business. I’m sure my mortgage broker will say “hey, we’ll wait until your practice grows”
No one likes getting 79 bucks. Please.
Anonymous
Actually I do know what I am talking about. I don’t sign any of those contracts, charge everyone the same fair fee. Integrity has it’s price, just as selling out has it’s payoff. My neighbors are teachers and policemen, not doctors as my house is worth the median home in this town. But there is no mortgage broker as it is paid for. For me it is as simple as the golden rule. I would be pissed if I found out someone sold me something for 700 that he was willing to sell to my neighbor for 70. I wouldn’t want that done to me, so I am not going to do it to them.

Hospitals Struggle Over Who Can Afford To Pay

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