Democratic Underground Latest Greatest Lobby Journals Search Options Help Login
Google

Are nonprofit hospitals gouging the poor?

Printer-friendly format Printer-friendly format
Printer-friendly format Email this thread to a friend
Printer-friendly format Bookmark this thread
This topic is archived.
Home » Discuss » Archives » General Discussion (Through 2005) Donate to DU
 
davsand Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-29-05 01:58 PM
Original message
Are nonprofit hospitals gouging the poor?
Here you go--one of the BEST articles I've seen that explains a bit about what is going on in the healthcare industry right now.

I have been hip deep in this issue for a few years now, and I am AMAZED to finally see an article that puts it in terms a lot of people might be able to absorb.

I know some people inside a couple of the Scruggs cases, and I can tell you that they are sincere in what they are trying to do. I also can tell you that the only changes we will EVER see in our health care system will be the ones we FORCE on that industry.

Please, read this article and send it on to people you know. We all have to be working to change this. If we want to ever see the day when hospitals act like charities we had better get busy...


http://www.msnbc.msn.com/id/6882630 /

"...Forty-six suits have been filed in 22 states, including one against Virginia's Inova Health System, alleging the hospitals violate their tax-exempt status by charging uninsured patients the highest rates and employing abusive tactics to collect.

"Their goal is to discourage these uninsured patients from returning," said Richard F. Scruggs, the lead attorney. "If they paid taxes, I couldn't complain. But these hospitals are given freedom from taxation for doing something."

Included in the cases is a California hospital with $1 million in an offshore bank account, another in Louisiana that owns a luxury hotel and health clubs, and a Georgia hospital that flew its executives on private jets to meetings in the Cayman Islands and Florida's Amelia Island. Because private insurers and the government negotiate deep discounts for their clients, the uninsured are usually the only ones charged the list price up to six times as much as for insured patients..."


How many of you knew about the Scruggs class action lawsuits and everything else going on with hospitals (including property tax exemption challenges)? Are they going on in your area?


Laura
Printer Friendly | Permalink |  | Top
rogue_bandit Donating Member (105 posts) Send PM | Profile | Ignore Sat Jan-29-05 02:11 PM
Response to Original message
1. Mental Health Parity
I don't know what's going on locally, but I do know that we took a poor friend suffering from serious mental illness in to the emergancy room on a cold, snowy night. They treated her like dirt, eventually she walked away and they didn't care. She was suffering from paranoia, in addition to voices, so they sent down three security guards to help her out...couldn't send a counselor or someone with compassion.

In our area, this is the only place to take someone suffering from mental illness. The county actually pays for something like eight beds all year round to help these people, and the hosptial gets special use of bonds in the city's name, and they get property tax relief and non-profit status.

They compete with another nearby hospital. Our town is a regional medical center. We have more sophisticated scanning devices per capita than any place in the northwest.

Ugly.
Printer Friendly | Permalink |  | Top
 
Lindsay Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-29-05 02:17 PM
Response to Original message
2. It just REALLY frosts me
that the government and media waste our time lying about a "crisis" in Social Security, while a real crisis in healthcare availability is downplayed or ignored.

Mental health is a big issue for me as well. I have suffered from major depression and anxiety off and on since high school, and the cost and (lack of) availability of treatment is not helping matters any.

Printer Friendly | Permalink |  | Top
 
ynksnewyork2 Donating Member (138 posts) Send PM | Profile | Ignore Sat Jan-29-05 06:26 PM
Response to Original message
3. nothing new. it's been going on
for years.
Printer Friendly | Permalink |  | Top
 
Sgent Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-29-05 07:15 PM
Response to Reply #3
4. Ask me anything
Thoe hospital spoken of in the article is North Mississippi Medical Center. Although not on staff there, I know work with them on a variety of issues (and against them on others). They are actually one of the better that I've seen.

The real reason they reversed on the settlement is because of the conflict of interest issues. Probably 50% or more of the board does a significant amount of business with the hospital. In a small town, this is probably inevitable if you want community leaders on your board; however, in this case it is very extreme. Many of the board members have businesses who ONLY do business with the hospital system.
Printer Friendly | Permalink |  | Top
 
davsand Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-29-05 11:13 PM
Response to Reply #4
6. That is not an uncommon set up.
Seems like the folks on a lot of the Boards of hospitals end up doing a lot of business with those same hospitals. Makes me wonder just who is watching the store, and probably would raise more than a few tax payer eyebrows if people realized just how much money hospital boards make off the local community non-profit hospital.

It is a shame that agreement de-railed. We had been watching that with some interest. I know the bond ratings guys had really supported that hospital BECAUSE of that agreement. I have to wonder if they will revise those financial ratings downward now that the agreement is DOA.


Laura
Printer Friendly | Permalink |  | Top
 
Dastard Stepchild Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-29-05 07:17 PM
Response to Original message
5. Are you involved in health policy research/advocacy/service provision?
I ask because this is my area of focus in grad school, and I am always excited to meet others that have similar general interests in health care issues. :)
Printer Friendly | Permalink |  | Top
 
davsand Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-29-05 11:16 PM
Response to Reply #5
7. Pleased to meet-cha!
I kind of fell into this issue, and have stayed active with it... I must not be doing too badly with it--I've pissed off a lot of folks thus far.

Check your in-box, I sent you a PM.


Laura
Printer Friendly | Permalink |  | Top
 
Dastard Stepchild Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 11:17 AM
Response to Reply #7
16. Back at ya!
I have replied to your PM :)
Printer Friendly | Permalink |  | Top
 
proudbluestater Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 04:46 AM
Response to Reply #5
8. It needs more cow bell n/t
Printer Friendly | Permalink |  | Top
 
Dastard Stepchild Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 11:18 AM
Response to Reply #8
17. If only this were the solution to everything in life...
More cowbell.
Printer Friendly | Permalink |  | Top
 
proudbluestater Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 04:54 AM
Response to Original message
9. I've heard all hospitals overcharge those with no insurance
Not just non-profits.

"Because private insurers and the government negotiate deep discounts for their clients, the uninsured are usually the only ones charged the list price up to six times as much as for insured patients..."


This is probably for another thread, but what irks me is the FOR profit hospitals that compete to see who can have the best equipment, facilities, whatever.

I live in a town with two major hospitals. One gets a PET scanner. The one down the road rushes out to get their own PET scanner. One has been doing Flightcare helicopter transporting for decades. Suddenly the one down the street decides it, too, must have a helicopter. This is just a VERY COSTLY duplication of services which also drives the cost of health care through the roof.

Rant off.




Printer Friendly | Permalink |  | Top
 
loyalsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 05:09 AM
Response to Original message
10. If you think this is bad
you should check into MDA. Talk about a bunch of criminals!!
One thing I didn't see here was that there is a huge segment of the population getting tax breaks from their "pat on the back" donations. If you have an argument with a person who has money about healthcare, they might point out their contribution without mentioning their tax deduction. Don't let them get away with it.
Printer Friendly | Permalink |  | Top
 
Sgent Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 06:07 AM
Response to Reply #10
11. Medicare was one of the chief instigators
of the cash patients pay more.

Under criminal fraud statues -- which have been heavily enforced against both physicians and hospitals, you got 5 years in prison for every incident of charging a cash patient less than a medicare patient. This also applied to insurance companies.

For this reason, cash prices were set about 10-20% above (or more) of the highest known contracted rate. This was because insurance companies often raise rates without telling people, and if your price was lower than their "allowable", you left money on the table.

About a year ago (maybe 18 months), CMS and the DOJ issued guidelines on cash discounts and on reducing fees for the indigent. A LOT of hospitals and physicians are now implementing this as part of their regular practice, but it does take time. Most doctors at least always felt the the cash patients were getting screwed, but their hands were tied -- it wasn't worth going to jail over.
Printer Friendly | Permalink |  | Top
 
loyalsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 07:25 AM
Response to Reply #11
12. What does this have to do with my post
??
Printer Friendly | Permalink |  | Top
 
Sgent Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 07:56 AM
Response to Reply #12
13. See Post 9
I'm still kind of new, and haven't quite figured out this "thread within a thread".
Printer Friendly | Permalink |  | Top
 
loyalsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 09:10 AM
Response to Reply #13
14. Ok
We're touching on two entirely different things. What you're discussing has nothing to do with what I mentioned.
MDA is the Muscular Dystrophy Assoc. They pay big bucks to CEOs. What has Jerry Lewis done that he would be rich at this point in his life?
Propped kids up for pity in search of a cure. Never entertaining the notion that they might live and need to adapt. When someone found this offensive here's what he had to say....

http://www.impactcil.org/Readings/jerry.html

When self interest enters into non-profits, the results can be very ugly. Unfortunately, they U.S. has assumed that that is the way to make them run most successfully. So we get Phrama and other bioindustries with the incentive to partner up and exploit them after all of your friends and neighbors who want to save a couple of bucks on their taxes have kicked in. Some people with disabilities might begin to feel like they're being experimented on.

http://www.sfbg.com/SFLife/35/48/cult2.html
Printer Friendly | Permalink |  | Top
 
davsand Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 10:55 AM
Response to Reply #11
15. I recently reviewed an article due out soon on that issue.
I'm bound by agreement not to release the article or any of its parts prior to its publication this summer, but essentially there are some safe harbors for hospitals who want to discount. You will see some movement there in the next few months.

The AHA (American Hospital Assoc) requested clarification from Tommy Thompson about discounts for the uninsured back in Dec of 2003. In Feb of 2004 Tommy Thompson responded. His response was direct--in that--it says there is NOT a problem with providing discounts to uninjured or medically indigent patients. However, his response also left a lot of ambiguities that still need to be cleared up.

I know there are several hospitals who would LIKE to provide more assistance to low income folks, however, they need some guidance before they can proceed. I was horrified to see that collection practices were outlined in the prior HHS guidelines--and that is just the beginning of the crap our government has done to the American medical consumer.

I'll grant you, some of the practices were put there to limit fraud, but others were just plain hurtful to poor people.

I talked to one of the players the other day and his comment was we really just need to get the AHA, HHS, the hospital finance guys, and a few of the activists together in a room and get it all hashed out. I think he's got a good idea, but I'm not expecting it to happen until there is enough pressure brought to bear on the hospital industry and the government to make it worthwhile for them. Right now, it isn't.

Scruggs' lawsuits and local property tax challenges are ramping up the pressure. If Scruggs gets some traction in some of the state level class action suits you might see a different set of attitudes.

If consumers start kicking legislators in the backside maybe you'll see movement.

Maybe if the hospital bond and finance guys get worried enough you'll see some action.

However it comes to pass, I think the face of the health care industry is changing.


Laura


Printer Friendly | Permalink |  | Top
 
Sgent Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-30-05 04:15 PM
Response to Reply #15
18. Even before the AHA request
was the request by NACHC (Natl. Assn. of Community Health Centers) to the HHS OIG to clarify requirements and create a safe harbor for sliding fee patients. Circa 1998 or so.

The resulting letter from OIG was very damning, provided no safe harbor, and basically told everyone it was very questionable. The unwritten rule was that they *might* not violate various statues, but they refused to say when that would be the case. CHC's, in poor areas and with government grant funding, decided to go ahead on the premise that they won't mess with us.

Everyone else, was fearful, and locked into the technique of do everything by the book and make sure we are safe. Thompson's statements a few years ago is what has opened up the field. Many hospitals and private physicians now offer cash discounts, sliding fee's, and the like.
Printer Friendly | Permalink |  | Top
 
davsand Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Feb-01-05 10:09 AM
Response to Reply #18
19. Do you remember specifics on this one?
We had a Seniors' program locally that was terminated by a hospital who claimed it was illegal based on much of what you are describing. At the time, the community group was able to demonstrate pretty clearly--they thought--that waiver of the Medicare shortfall was not a legally troublesome issue. Now, I'm starting to wonder about it...

Can you shoot me a PM with some info on this-PLEASE???

Thanks!


Laura
Printer Friendly | Permalink |  | Top
 
DU AdBot (1000+ posts) Click to send private message to this author Click to view 
this author's profile Click to add 
this author to your buddy list Click to add 
this author to your Ignore list Fri Apr 25th 2014, 12:18 AM
Response to Original message
Advertisements [?]
 Top

Home » Discuss » Archives » General Discussion (Through 2005) Donate to DU

Powered by DCForum+ Version 1.1 Copyright 1997-2002 DCScripts.com
Software has been extensively modified by the DU administrators


Important Notices: By participating on this discussion board, visitors agree to abide by the rules outlined on our Rules page. Messages posted on the Democratic Underground Discussion Forums are the opinions of the individuals who post them, and do not necessarily represent the opinions of Democratic Underground, LLC.

Home  |  Discussion Forums  |  Journals |  Store  |  Donate

About DU  |  Contact Us  |  Privacy Policy

Got a message for Democratic Underground? Click here to send us a message.

© 2001 - 2011 Democratic Underground, LLC