The Chicago Sun-Times reported that Illinois state Attorney General Lisa Madigan wants legislation that would force not-for-profit hospitals to provide more free care to the poor.
She cited a 2003 report that most hospitals provided charity care worth less than 1% of the hospitals' total charges. The Illinois Hospital Association (IHA) countered that "these statistics can be misleading for a number of reasons, partly because hospitals only collect a portion of what they charge, and charity care amounts don't reflect the compenstated care hospitals provide when bills go unpaid."
On the other hand, I wonder if these amounts were compared to the charges for specific services some hospitals make to uninsured patients, which are often much higher than those for those same services negotiated with insurance companies and managed care. If they were compared to those much higher charges rather than what the hospital usually accepts for insured patients, even these figures could have inflated the amount of charity care provided.
The IHA also "doesn't like the idea of any law dictating hospitals' charity requirements. An IHA task force report written last year says such mandates run the risk of shifting costs to insured patients and causing cuts in hospital services."
I agree that trying to address this problem with legislation specifying charity care amounts may be heavy-handed. A potentially more flexible approach would be to give more power over this issue to a state regulatory board.
But I'm afraid this heavy handed approach may seem attractive after numerous stories of hospitals "'gouging' those without health insurance by charging them much higher rates than what's paid by government-run Medicare and Medicaid programs or by private insurers, who have the clout to negotiate steep discounts." "Hospitals also have been chastised for overly aggressive attempts to make financially strapped patients pay up." [Quotes from the Sun-Times.]
These ongoing issues make it particularly worrisome that some thought leaders are now advocating giving hospital managers even more power to enforce ethical standards covering physicians (see post here).
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