Killer Hospital Bills

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While the healthcare debtate rages on, every day uninsured Americans are faced with a lot of hard pills to swallow. Their hurdles serve as a reminder of why healthcare reform is needed.

“The way that my stomach was swollen and the pain, we all thought that was appendicitis” Dhavi Eustaquio told Money Talks News.

The diagnosis wasn’t appendicitis. Despite 8 hours of tests, doctors never figured out exactly what her problem was. The pain faded, and Eustaquio left the hospital, with a whole new problem.

“I get the bill and I almost had a heart attack. It was almost $12,000.”

This is a classic case in the world of the uninsured. Those without insurance skate, and those you can pay, do. Through the nose. It’s called cost or charge shifting. Find help for the uninsured in your state.

“Somebody needs to cover the economics, so the charges are increased for the paying patients to pay for the patient that doesn’t” said Baptist Health Chief Financial Officer, Ralph Lawson.

According to consumer advocacy group Consejo de Latinos Unidos, if Dhavi’s tests were covered by Medicare, they would have cost about $2,600. The average insurance company would have been charged about $2,900. But Davina’s bill? Nearly $12,000.

Since many uninsured people don’t pay, somebody’s got to pay extra. It’s not Medicare and it’s not insurance companies: they negotiate discounted rates. So who’s left?

“The uninsured, who are not poor enough to qualify for charity care, or Medicaid, yet not healthy enough or wealthy enough to have private insurance are the people who get stuck with these outrageously high medical bills” Patient advocate K. B. Forbes said.

So what’s the solution? System-wide, who knows? Hopefully the ongoing debate and pending legislation will address these and other pressing problems in our healthcare system. But until then, there are things you can do if you find yourself in Dhavi’s situation.

While there may be plenty of debate about how to fix the healthcare system, there’s almost no disagreement that it’s currently broken.

“The hospitals are balancing their books on the backs of the uninsured. Middle class, working class people, and that’s morally unacceptable” Patient rights advocate K.B. Forbes told Money Talks News.

Forbes is fighting a hospital system that he says, routinely charges insured patients as much as five times what uninsured patients pay for the same care. Simply put, hospitals lose so much money on uninsured patients who don’t pay–many send out ridiculously high bills to those that can.

“If somebody comes in and gets free care, obviously that’s a cost. We have to recover it from somebody” said Chief Financial Officer, Ralph Lawson of Baptist Health in Florida.

In Dhavi Eustaquio’s case, the hospital is trying to recover nearly $12,000. It’s the cost of a visit to the Emergency Room, which Forbes said, should have been more like $3,500.

“Now I’m not asking for free care, I’m asking to be charged what is reasonable,” Eustaquio adds.

Baptist Hospital C.F.O Lawson, admits patients like Eustaquio who don’t qualify for charity, should ask for help.

“Work with your local hospital system and see if you can’t negotiate a better price than what the list price might be” Lawson adds.

But what the hospital calls better, $6,000 in Dhavi’s case, Forbes believes isn’t fair. What he wants is for hospitals to simply charge uninsured patients 10% more than insured patient’s pay.

“Hospitals have to prove that their prices are reasonable and you do not have an obligation to pay a bill that has been grossly inflated.”

Bottom line, hopefully there’s help on the way for uninsured Americans. In the meantime, if you don’t have insurance, and find yourself with big bills, do what you can to negotiate a fair price.

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