Dunning the Sick

Whenever I hear people debating health care reform or talk about "Obamacare" I almost invariably hear the statement, "Well, even with the system today everyone is able to get medical care – hospitals aren't allowed to deny anyone care." I've always thought that to be a dumb argument because it seems like it's an incredibly inefficient and expensive way to provide health care to those who can't afford it, and reading this article on collection agencies working in hospitals seems to support the argument that it is indeed supremely stupid and expensive:

Still, hospitals are in a bind. The more than 5,000 community hospitals in the United States provided $39.3 billion in uncompensated care — predominately unpaid patient debts or charity care — in 2010, up 16 percent from 2007, the hospital association estimated.

So it's no surprise that hospitals would try to recoup some of their money through collection agencies. Unfortunately, the tactics at least one of these agencies is using seem to be encroaching on the health care delivered by the hospitals:

Collection activities extended from obstetrics to the emergency room. In July 2010, an Accretive manager told staff members at Fairview that they should “get cracking on labor and delivery,” since there is a “good chunk to be collected there,” according to company e-mails.

Employees were told to stall patients entering the emergency room until they had agreed to pay a previous balance, according to the documents. Employees in the emergency room, for example, were told to ask incoming patients first for a credit card payment. If that failed, employees were told to say, “If you have your checkbook in your car I will be happy to wait for you,” internal documents show…

Patients with outstanding balances were closely tracked by Accretive staff members, who listed them on “stop lists,” internal documents show. In March 2011, doctors at Fairview complained that such strong-arm tactics were discouraging patients from seeking lifesaving treatments, but Accretive officials dismissed the complaints as “country club talk,” the documents show.

Nah, we don't need no stinking health care reform.

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