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Hospitals Versus the Uninsured

August 2004

Michel Martin of ABC News reported on July 7, 2004 that "there are 44 million people in this country without health insurance". That doesn't make a great deal of sense all by itself, but that's only the kick-off point. Let's assume that one of those 44 million people gets injured or sick and needs hospital care. There are all kinds of not-for-profit hospitals around the country and in exchange for their tax exempt status, they are expected to treat patients even if they don't have insurance. The ones without any money, or the older patients, will have Medicare or Medicaid. So we're not talking about them. Nor are we talking about those among us who are insured through our employers. We're talking about people who have a little money but no health insurance. Would you assume that not-for-profit hospitals charge these people less, the same, or more than those who are covered by insurance?

Remember now, I said that almost nothing about this story makes much sense. It turns out that because Medicare and the HMOs, the private medical insurance companies, have a lot of bargaining power with the hospitals, that they can negotiate hospital fees down. Whereas the patient without any medical insurance at all is often charged two, even three times as much as the person with health insurance. Not only that, these so-called charitable not-for-profit hospitals employ some pretty uncharitable techniques to collect on their bills.

If you do not have medical insurance and you are paying or being charged by a hospital for services rendered, you may have been overcharged.

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