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What you need to know for 08/20/2017

Hospitals should bill uninsured more realistically

Hospitals should bill uninsured more realistically

Editorials: Don't make consumers haggle

The smart consumer’s mantra, “never pay retail,” isn’t always an option for health care consumers who lack insurance, which is one reason why Obamacare will be worth the price of admission when it’s fully implemented.

Too many Americans (48 million) lack coverage for hospital care, and when an emergency strikes, the bills sent to them are often staggering — much higher, initially anyway, than the reimbursement rates paid by Medicare, Medicaid and private insurers. No wonder a lot of people simply don’t pay; they can’t afford to.

And then there are the ones who are onto the hospitals’ strategy of inflating retail costs in an effort to get insurers to pay more. Maybe if hospitals billed uninsured customers closer to their actual costs right off the rip, instead of waiting for them to complain about charges like $3 for a couple of aspirin or $75 for Band-Aids before cutting them some slack, more of them would be able or willing to pay.

Instead, hospitals are instituting legal proceedings against deadbeats with increased frequency, as Marlene Kennedy’s “Down to Business” column reported in Thursday’s Gazette. For example, she cited Glens Falls Hospital bringing 41 civil suits against former patients one day and 19 the next in an effort to recover close to $300,000 in unpaid bills.

Rising health care costs and the Great Recession proved to be a double whammy on Americans who may have been uninsured to begin with or who lost their jobs and/or insurance along the way. Not surprisingly, uncompensated care at Capital Region hospitals rose more than 40 percent, to $78.4 million a year, since 2008.

We suspect some of those people would have been more willing and/or able to make good on their debts if hospitals had been more reasonable about billing them in the first place. Some eventually provide discounts, but still not as steep as they accept from government and large private insurers.

Obamacare may eventually render this problem moot, but until it does, hospitals need to find a way to charge the unfortunate uninsured closer to what their actual costs of care are, and not more than they’re willing to accept from insurers.

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