Uncharitable Care: How Hospitals Are Gouging & Arresting the Uninsured

whoah! this is fucking sick shit for the "Greatest Country"

http://www.commondreams.org/headlines04/0108-07.htmPublished on ow!

What do the Emir of Kuwait and the working poor of the United States have in common? Not much, except when it comes to paying for health care in the United States. They all pay the highest price: up to 500% more than the hospital receives from insured patients.


Jennifer Kankiewicz was rushed to New York's Beth Israel Hospital in July 2002 for an emergency appendectomy and was hospitalized for two days. "I waited through a day's worth of not being able to get out of bed because I didn't have health insurance," recalls Kankiewicz. "The next day, a friend drove me to the hospital in an emergency and we went to the closest hospital we knew of."

Kankiewicz had an emergency appendectomy. "They provided great service," she says. The hospital "reassured me that I could apply for Medicaid assistance. So I thought, maybe Medicaid would help me with the $24,000 that it cost me."

Though Kankiewicz is poor, she was not poor enough. She was denied Medicaid assistance because she makes $19,000 a year. In order to qualify for Medicaid, Kankiewicz either needed to be pregnant, disabled or earn less than $350 a week. Though she was able to convince her surgeon to slightly reduce the charges, she still faces over $19,000 in hospital bills, more than her annual salary. She says she is being billed by six separate billing groups and, unlike the big insurance companies; Kankiewicz has no negotiating power with the hospital or its collection agencies.

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In Kankiewicz's case, according to Benjamin, Beth Israel receives $28 million a year for charity or bad debt cases. But rather than establishing a process to inform patients about applying for this money, Beth Israel made Kankiewicz go through the process of applying for Medicaid.

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many uninsured patients end up with huge medical bills and no way of paying them. Hospitals then hound them for payment using collection agencies and lawyers, who employ such methods as filing lawsuits, slapping liens on homes, seizing bank accounts and garnishing wages to extract payments. Some hospitals now rank among America's most aggressive debt collectors.

" don't know they have been sued because the collection attorneys and the collection agent hired by the hospitals are voracious," says Benjamin. "They claim to serve people, but in fact they have never served anybody with court papers. The next thing my clients know, their bank accounts have been taken."

But for some people, it can get worse than that.

A Return to Debtors Prisons

Hospitals in several states have actually had patients arrested and jailed if they are unable to pay their debts. This legal tactic is chillingly known as body attachment.

"Body attachment is basically a warrant for arrest," says Claudia Lennhoff, executive director of Champaign County Health Care Consumers in Illinois. She says that if a patient misses a court date, that they may not even know they have, the attorneys for the hospitals or collection agencies can ask the judge to issue a warrant for the patient's arrest.

more scary crap....

Welcome to the new vision of America.

we may see a rise in a phenomenon that is common in Japan.

It is nearly impossible for an individual to declare bankruptcy in Japan, so while medical bills are rarely a problem due to the option for national health insurance, people can become dangerously overwhelmed with consumer debt, mortgages, and last-resort loans from loan sharks.

In such cases, people choose to disappear. They just walk away from their previous lives and go join the underground economy.

previously middle-class citizens - people who, unlike the inveterate poor, are not used to cowering in the face of authority - start encountering poverty and the outrageous injustice that comes with poverty. These people are used to pushing back.

...that hospitals are no longer doing cost shifting onto insured patients to pay for the uninsured, but are now price gouging uninsured patients to subsidize the insured!!!

Yes, hospitals charge uninsured patients three to five times what they charge an insurance company for the same goods and services. Although you can often negotiate a huge bill down to something a little more reasonable, you will still pay more than any insurance company does, and you WILL pay, one way or another.

What they usually do is put a lien on any real property you own until that bill is paid. If you don't own a home or a new car or anything else they can attach, they will garnish your paycheck, leaving you nothing to live on. If you don't have a job, you're in better shape, because they will take everything down to the Medicaid qualifying amount ($1500 in this state, an amount unchanged since the 1950s) and petition the state for Medicaid. You will be destitute. They will be paid.

Welcome to the best healthcare system in the world, according to Congress, who enjoy the best socialist system in the world while leaving us to this crap.

had a neat racket going. They even got themselves investigated by the WSJ in 1996, for performing unnecessary procedures on people in West Texas, and then foreclosing on their property when they couldn't pay. The investigation mysteriously came to a grinding halt and I never heard anything more about it. I volunteered to testify if the case ever went to trial. Those bastards were easily pulling in a million/year each and tehre were seven of them in the group.

I am surprised that people don't snap in these situations.
What would you do if you were arrested for not showing up
at a court hearing you didn't know about, concerning a bill
you had no possible way of paying. Better yet, what if the
hospital had charged you will a bill you did not owe -
mistaken identity.
This is the stuff of civil war.

Any doctor, clinic or hospital that accepts Medicare or Medicaid payments has to demonstrate that it's list prices for medical services are equal to or greater than what it charges Medicare and Medicaid patients. Because the government is worried about sham list prices, it also requires that the list prices actually be charged to patients and that doctors, hospitals diligently try to collect unpaid bills. Failure to charge list price, or diligently try to collect unpaid bills is criminal fraud with rather severe penalties.

However, the government does allow doctors, clinics and hospitals to negotiate discounts with HMO's, health insurers and other similar groups. What this boils down to is: (1) the list price is usually by far the highest price charged for a given medical service; and (2) only the uninsured are expected to pay the list price.

I work for a healthcare organization. We raised our prices specifically so we could get more money from others to compensate for the lack of money coming in from Medicare/Medical (the California version of Medicaid).

The government will not support a universal health care program, and does not know how to support the health care programs it has. For example, a new health care law HIPAA requires every health care agency to use new codes for billing to streamline billing of patients (ie to save money and make bills more understandable). Companies were supposed to comply in October of 2003--but Medical did not comply.

In addition, medical is cutting even more the amount it reimburses for services. What else can a legitimate company accepting government insurances do but charge others more in order to compensate for being underpaid by the government?

I didn't know that it was legal to jail people for not being able to pay a debt. Unbelievable. That is the scariest part of it.

for a prescription for infection out of hospital emergency room. The very poor have medii-cal but many many don't. And still, thats alot of money for a prescription. Thats on top of the 10 hrs you'll be in the waiting room waiting to get in to see the 'intern' and the 30 second chat with the doctor (200$).