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eridani

eridani's Journal
eridani's Journal
December 22, 2014

When Nonprofit Hospitals Sue Their Poorest Patients

http://readersupportednews.org/news-section2/318-66/27624-when-nonprofit-hospitals-sue-their-poorest-patients

On the eastern edge of St. Joseph, Mo., lies the small city's only hospital, a landmark of modern brick and glass buildings. Everyone in town knows Heartland Regional Medical Center — many residents gave birth to their children here. Many rush here when they get hurt or sick.

And there's another reason everyone knows this place: Thousands of people around St. Joseph have been sued by the hospital and had their wages seized to pay for medical bills. Some of them, given their income, could have qualified to get their bill forgiven entirely — but the hospital seized their wages anyway

Nonprofit hospitals get huge tax breaks — they are considered charities and therefore don't pay federal or state income tax or local property tax. In exchange, they are obligated to provide financial assistance or "charity care" to lower-income patients.

Some nonprofit hospitals around the country don't ever seize their patients' wages. Some do so only in very rare cases. But others sue hundreds of patients every year. Heartland, which is in the process of changing its name to Mosaic Life Care, seizes more money from patients than any other hospital in Missouri. From 2009 through 2013, the hospital's debt collection arm garnished the wages of about 6,000 people, according to a ProPublica analysis of state court data.
December 20, 2014

How health care as a commodity screws both the poor and the affluent

A commodity is something you can have only if you have the money. It makes our health care vastly more expensive in two ways.

If you don’t have money, you can’t pay to treat problems when they are still cheap to treat, as in the case of the Maryland boy whose mother didn’t have $85 to extract an infected tooth. The infection spread to his brain, and the people of Maryland paid $230,000 to try to save his life. He died anyway.

On the other hand people who do have money (or good insurance) are oversold on unnecessary care. We spent $750 billion on unnecessary health care in 2011, about a third of all health care expenses. Invasive procedures that are unnecessary can result in injury or even death.
http://www.washingtonpost.com/blogs/wonkblog/wp/2012/09/07/we-spend-750-billion-on-unnecessary-health-care-two-charts-explain-why/

Health care policy is unique in that it is the only social issue where the morally right thing to do is also the cheapest thing to do.

December 14, 2014

U.S. Health Care Lags Worldwide for Those Over 65

http://newoldage.blogs.nytimes.com/2014/12/12/u-s-health-care-lags-worldwide-for-those-over-65/?hpw&rref=health&action=click&pgtype=Homepage&module=well-region®ion=bottom-well&WT.nav=bottom-well

“It’s definitely a better picture than when we look at the U.S. population generally; that’s a pat on the back for Medicare,” said Robin Osborn, director of the fund’s International Health Policy and Practice Innovations program and lead author of the study. Previous research has shown that “Medicare is more protective than all the different insurance plans people have under age 65,” she said.

The bad news first:

■ Our older population is sicker. We lead the list in the proportion of people over 65 who have two or more chronic diseases (68 percent report hypertension, heart disease, diabetes, cancer, etc.) and who take four or more prescription drugs (53 percent). Only a third of seniors in the United Kingdom have multiple chronic conditions. (The survey didn’t include residents of nursing homes or other care facilities.)

“One thing we know contributes to this is not having an ongoing, stable source of health insurance throughout your life,” Ms. Osborn said. Before they became Medicare-eligible, American seniors may have forgone preventive treatments or let conditions worsen because they couldn’t afford care.

■ Older Americans still struggle to pay for health care. Nineteen percent said that in the past year, cost was a barrier that prevented their seeing a doctor, undergoing a recommended test or treatment or filling a prescription. In only one other surveyed nation (New Zealand, at 10 percent) did that proportion reach double digits.


Among American seniors, 21 percent had out-of-pocket medical expenses that topped $2,000 and 11 percent had problems paying their medical bills. In Norway and Sweden, 1 percent had problems paying; in Germany, 3 percent.

“As good as Medicare is – it provides excellent coverage over all – it still isn’t as protective as the coverage people get in other countries,” Ms. Osborn said. Its deductibles and cost-sharing requirements still leave many Americans scrambling to afford drugs and doctors – which also cost more here.


December 1, 2014

Cost Still a Barrier Between Americans and Medical Care

http://www.gallup.com/poll/179774/cost-barrier-americans-medical-care.aspx

One in three Americans say they have put off getting medical treatment that they or their family members need because of cost. Although this percentage is in line with the roughly 30% figures seen in recent years, it is among the highest readings in the 14-year history of Gallup asking the question.

Last year, many hoped that the opening of the government healthcare exchanges and the resulting increase in the number of Americans with health insurance would enable more people to seek medical treatment. But, despite a drop in the uninsured rate, a slightly higher percentage of Americans than in previous years report having put off medical treatment, suggesting that the Affordable Care Act has not immediately affected this measure.

The percentage of Americans with private health insurance who report putting off medical treatment because of cost has increased from 25% in 2013 to 34% in 2014.

This year, 22% of Americans say they have put off medical treatment for a "very" or "somewhat serious" condition.

One of the goals of opening the government exchanges was to enable more Americans to get health insurance to help cover the costs of needed medical treatments. While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost
.

Underinsurance Remains Big Problem Under Obama Health Law

http://www.nytimes.com/2014/12/02/upshot/underinsurance-remains-big-problem-under-obama-health-law.html

The A.C.A. has not done as much as many had hoped it would to reduce underinsurance. In fact, it may be helping to spread it. And proposed modifications to the law, like those that would introduce a new tier of “copper” plans in addition to bronze, silver, gold and platinum, might make underinsurance worse.

The point of having insurance is to be able to get care when you need it, without too large a financial burden. Underinsured Americans are not receiving this benefit, though. They can’t get the care they need. Twenty-seven percent of adults with a deductible large enough to render them underinsured didn’t see the doctor when they were sick; 23 percent didn’t get a preventive care test; 29 percent skipped a test, treatment or follow-up appointment; and 22 percent didn’t see a specialist to whom they were referred. Forty percent of them had at least one of these cost-related access problems.

These are people who had private health insurance for the full year. They are not the uninsured.

In the quest for universal coverage, it’s important that we not lose sight of “coverage” in order to achieve “universal.” The point of improving access is, after all, to make sure that people can get, and afford, care when they need it.


Comment by Don McCanne of PNHP: Health care reform should have eliminated underinsurance, not create more of it. The private insurance industry will not fix this problem but only compound it as it strives to keep its premiums competitive.

We need to replace the private insurers with our own single payer program. For some, Medicare is also underinsurance. We need to fix that and then provide it to everyone.

(Posted as a comment on the NYT website as a response to Aaron Carroll’s article.)

Profile Information

Gender: Female
Hometown: Washington state
Home country: USA
Current location: Directly above the center of the earth
Member since: Sat Aug 16, 2003, 02:52 AM
Number of posts: 51,907

About eridani

Major policy wonk interests: health care, Social Security/Medicare/Medicaid, election integrity
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