Solution Must Include Uncompensated Care

On September 26, 2009, Joy Stephenson’s article on “Uncompensated Care” was published in two Southern California newspapers, the Inland Valley Daily Bulletin and San Bernardino Sun. Below is an unedited copy of the article or you can visit the links.

San Bernardino Sun Article                       Inland Valley Daily Bulletin Aritcle

 

Solution Must Include Uncompensated Care
Joy Stephenson

The current debate over health care reform is a much needed one.

Everyone, from politicians to the health care industry to consumers, all agree and recognize that access to affordable, quality health care is critical for the future well-being and prosperity of our nation. But in the debate over possible solutions, we also must look at aspects of our current health care system that, if left as they are today, could easily undermine all the good we are trying to achieve with this reform.

One of these areas is "uncompensated care," or the care that hospitals, by law, are required to give whether or not they are ever compensated by patients, insurers or the government for its true cost.

Everyone likely would agree that ensuring this type of access is a reasonable and fair-sounding proposition that contributes to the greater good. Indeed, countless numbers of people have received urgent and needed medical attention that they otherwise would not have received because of it.

Unfortunately, no one could have foreseen that providing this care without having any mechanism in place to fund it would eventually raise the costs of health care in the United States to incomprehensible levels that would threaten to cripple the health care system itself.

The numbers involved are simply staggering and impact the financial well-being of virtually every player in the health care delivery system. In 2008 alone, U.S. hospitals provided upwards of $42 billion in care which went unpaid because of patients having insufficient or nonexistent health insurance. This situation is further exacerbated by the fact that many underinsured or uninsured Americans use the emergency room as a substitute for nonemergency care, which results in some of the most basic medical care being provided at the higher costs associated with an ER.

To help offset these losses, hospitals and doctors need to charge everyone more for the services they provide. These higher prices then create a corresponding increase in the costs to insurance companies and other health care payment programs. They, in turn, pass these on to consumers and businesses that purchase their insurance coverage in the form of higher premiums. The result is a seemingly never-ending spiral in the escalation of health care costs.

We are now reaching a point where the hospitals providing the most needed care to some of the United State's most vulnerable populations are facing the very real prospect of financial collapse and closure because of the levels of uncompensated care they provide. Ensuring that those most in need of health care can continue to receive it while the hospitals that provide this care are adequately compensated so they can keep their doors open must be an element of the current debate on health care in this country.

Additional government grants and health care charity private funding are two possible options to ease the strain on hospitals. Public outreach to enroll more low-income Americans who qualify for subsidized coverage will also help offset some costs. There are countless charities that address illnesses and research cures for terminal and debilitating diseases, but without viable hospitals where the treatment is done, these charities can do nothing.

Joy Stephenson is founding and managing partner of Stephenson, Acquisto & Colman (SAC), a law firm that specializes in representing major California hospitals.