Fresh Pain for the Uninsured

[babylonsister]

Fresh Pain for the Uninsured
As doctors and hospitals turn to GE, Citigroup, and smaller rivals to finance patient care, the sick pay much more

by Brian Grow and Robert Berner


In a lucrative new form of fiscal alchemy, a growing number of hospitals, working with a range of financial companies, are squeezing revenue from patients with little or no health insurance. April Dial's dealings with Hot Spring County Medical Center in Malvern, Ark., illustrate how the transformation of medical bills into consumer debt means quicker cash for medical providers but tougher times for many patients of modest means.

Dial, a 23-year-old truck-stop waitress who earns $17,000 a year plus tips, suffers from Type 1 diabetes. Sudden drops in her blood sugar level have sent her to the emergency room four times in the past three years. In September she spent three days at Hot Spring, including two in intensive care, fighting complications from her ailment. The bills came to more than $14,000. Dial's job offers no health insurance.

Until recently her mother, Carolyn, who waits tables at the same roadside diner, sent Hot Spring $100 a month under the nonprofit hospital's longstanding zero-interest payment plan. Dial says she couldn't make payments herself because she spends more than $150 a month for other treatment and insulin.

Sophisticated Help

In October she learned that Hot Spring had transferred her account to a company called CompleteCare, one of the many small firms fueling the little-known medical debt revolution. Enticed by the enormous potential market of uninsured and poorly insured patients, financial giants such as General Electric (GE), U.S. Bancorp (USB), Capital One (COF), and Citigroup (C) are rapidly expanding in the field or joining the fray for the first time. CompleteCare informed Dial that under the complicated terms of her newly financed debt, her minimum monthly payment had shot up more than fourfold, to $455. Dial says she doesn't have anywhere close to that amount left over after rent, food, and other doctor visits: "Every extra dime I have goes to paying medical bills."

Collecting from "self-pay" patients like Dial has long been the bane of medical administrators. When they don't get paid immediately, hospitals typically recover around 10¢ on the dollar owed, even when they hire collection specialists. So hospitals and clinics are bringing in more sophisticated help. They are transferring patient accounts wholesale to finance experts, banks, credit-card companies, and even private equity firms. Many of these third parties use credit scores and risk-analysis software to price the debt and impose interest rates as high as 27% on past-due bills.

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http://www.businessweek.com/bwdaily/dnflash/content/nov2007/db20071120_397008.htm?campaign_id=rss_daily

[dysfunctional press]

1. tell third-party collectors to go to hell...they can't do a damn thing.

and they don't generally spend too much time/effort on debts that will obviously ultimately be written off.

[thecrow]

2. We live in a corporation-owned world

and corporations are very self centered, not people centered. If I was king, I'd outlaw all these corporations.

[tech3149]

3. It might be a fresh pain to me, but I've seen it far too long.

For those that don't know, hospitals especially have been billing uninsured patients at a much higher rate than an insured patients carrier pays since the late 80's. I think it was in the 90's that they started referring collections to collections agencies empowered to collect the full amount bay any legal means available. Garnish wages, seize assets, whatever it takes, but the collection agent gets a cut and the more they collect the better the cut.

I had an incident recently where I passed out, dizzy, unable to focus, passed out for a few seconds, so the people I was with called 911. EMS arrives, take vitals, start saline IV, head to hospital. Go through the whole ER drill, full monitoring, 12 point EKG, multiple sample blood test, chest xray, comparison in different physical positions. History and Physical interview indicates no predisposition to any condition. I didn't tell them that something similar happened well ovetr a few decades ago at a coffee house after chain smoking and sucking up coffee for hours. At 16 that's a lot of chemical intake, I was no uber-healthy jock, but I figured it to be my safety valve.

Long story shorter, the final tally for ambulance, ER, Lab, Radiology, et al was about 3K. I'm a NINI (no income no insurance)and I'm pretty sure without arguing with billing, I'm paying at least twice what an insurance carrier would have paid. That frosts me to no end. But I'm a nice guy, I used to work with these people a couple of decades ago. I'm lucky, I had the assets to cover the bills, but it is a serious pinch. If I were dead broke and working at Sheetz for $6:50/hr and couldn't sell my car to pay the bill, I'd disappear real quick.

[Skarbrowe]

4. I just paid off 4 grand for a 2 hour visit to the ER.

On June 4th I got what I thought was something so bad it was going to kill me. I chose to stay in my bed and die at home. After 9 days of 102 degree plus fever, my roommate finally took me to the emergency room. They gave me intravenous tylenol, took two X-rays, I talked to a doctor for about 3 minutes and they said I had a bladder infection. Sorry, what I had that first couple of days was no bladder infection. I have something else wrong with my kidneys that keeps me in a mild bladder infection state. In other words, the hospital did nothing for me but give me a script for Cipro. My mistake was going to the ER instead of having someone prop me up and drag me into a clinic. For a few bucks I could have gotten the same damn script. After being sick for 9 or 10 days and not getting rid of the fever ( lost of a bunch of weight, which was the best thing about it all) I thought maybe the ER would actually give me some tests and find out what was happening to me. Nope. I still don't know. I have decided to NEVER go to the emergency room again.

Oh, I use the VA for all meds and doc appointments and they are free. I am extremely thank-ful for that. I don't know what the VA would have charged if my roommate had taken me an hour or more away to the nearest VA hospital. It's so bad. I think it's much worse for other people than for me. At least I am getting some care, maybe not the greatest, but at least some and it's free.