Thursday, January 08, 2009

Wallet Biopsy

Have you ever had a wallet biopsy?

Probably not, but according to Business Week this is a practice that can be eye opening.

Hospitals are forbidden from refusing service, regardless of ability to pay, when you have a life threatening emergency. They are required to treat you, at least up until the point your condition is stabilized.

But after that, they can withhold services if you lack the ability to pay.

Debbie Maupin, 41, already has felt the procedure's sting. The Dallas resident fractured her skull, neck, and back in a car crash in April 2005. Parkland Health & Hospital System gave her free care worth more than $100,000 because her job as a mortgage adviser offered no health insurance. When she returned in June 2006 for a scheduled CAT scan, however, Parkland told her she no longer qualified as a charity case "because my credit score was too high," she says.

Granted, a high credit score means you have demonstrated an ability to manage your money . . . it does not mean you have money in the bank.

Still, I have a problem with someone who does not have health insurance and uses the excuse that they do not have insurance because their job doesn't offer it. We know nothing about her health before the accident, or her income, but apparently it was too high to qualify for Medicaid. It is possible she could have purchased health insurance, but simply chose not to.

So why didn't she purchase health insurance on her own?

Parkland analyzes credit scores when deciding who can afford to pay for care.

They also look at credit card balances, 401(k) balances and estimates of income. What's wrong with that?

"We are very generous in our charity care, giving over $100 million in free care last year,"

Hospitals give away millions each year in uncompensated care. One of our favorite topics here is Grady hospital, the local taxpayer funded, charity hospital. We recently pointed out that Grady is auditing those who receive free care and letting them know the party is over.

Evelyn Leonard earns $18,000 per year. According to Halifax Medical Center in Daytona Beach, she meets their standard for charity care. When she wanted a procedure for a non-emergency treatment they offered a 50% discount.

She indicated she could not pay, so they asked about her 401(k) funds. She has opted not to tap those funds to pay for care.

Halifax's vice-president for patient business and financial services, won't comment on Leonard's case, citing patient confidentiality. "Part of our mission is to provide care to people who fall through the cracks, but we cannot incur a cost that taxpayers and the community cannot bear,"

Halifax is a taxpayer funded facility that gave away $41 million in uncompensated care last year.

I have no problem with my taxes going to pay for care for those who do not have the ability to pay, but I do take issue with those who fail to accept personal responsibility and purchase insurance or pay their debts.

All of us need to eat to sustain life. If someone walked into a grocery store, or restaurant, and helped themselves to food then walked out without paying, no one would think there was anything wrong with the grocer or restaurant owner pursuing payment.

But for some reason when someone has the ability to pay for health care, but refuses to do so, then there is a public outcry.

Something is terribly wrong with this picture.
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