Let's stop counting on charity to pay medical bills

Patrick,
I was hoping you would clarify and defend what ever point you were trying to make. Most of the Catholics and Methodists I've shared life's journey with are charitable and kind. But if you'd do just a little bit of homework, you'd realize that some hospital chains have kept the mantle, in name only, of the religious faith that founded them. They're now owned and/or run by huge, bureaucratic, and heartless corporate entities whose "mission" is to increase their "profit" margin. (They do it in a number of ways that are definitely not Christian, if you read and understand the parables of Jesus.)

What's in a name? The cloak of respectability perhaps. Call me a cynic or a discerning citizen, but as a nurse it appears to me that the religious cloak worn by some of these hospital corporations is more like a shroud that hides some very inconvenient truths. To quote the director of the Institute for Health and Socioeconomic Policy (IHSP), "The industry's survival as an industry is linked to its ability to be widely seen as legitimate, fair, and trustworthy by both the general public and the nation's caregivers."

Wonderful nurses and doctors work in these facilities, and they're doing their best, despite overwhelming odds, to provide care to the patients who trust them. There are true patient advocates and whistleblowers among them who are working to expose and remove barriers to their ability to provide the care patients need to restore them to optimal health. Some of these facilities employ utilization review clerks and case managers to delay admissions while waiting for "authorization," push for early discharges and transfers and look for other ways to cut corners and skimp on care to protect the corporate bottom line. That's not very charitable in my book. Say what? In the name of the father, son, and holy ghost, I'm discharging or dumping you, with your complex care needs into the streets, or unto the ranks of your unlicensed, unskilled family or friends with a set of instructions and a prescription that would challenge a newly graduated RN. Never mind whether you have the ability to pay for your prescriptions, that's not our problem. Amen!

If you know anyone who works in accounts receivable in a hospital, ask them how many millions of dollars they're owed in reimbursements from insurance companies, and how many of those millions are they writing off, because of insurance company denials and recissions. Speaking of administrative waste and overhead, Professor Uwe Reinhardt, who is also on the board of trustees of the 900-bed Duke University Hospital, used Duke to illustrate the problem: “We have 900 billing clerks at Duke. I’m not sure we have a nurse per (each) bed, but we have a billing clerk per bed…it’s obscene.” But, not to worry Patrick. We're talking big business in an industry that is often lacking in transparency and charity. The last study I read, published by IHSP, that was based on calculations of American Hospital Association data, showed record setting aggregate profits of over $309 BILLION dollars.

You've no doubt read about hospitals that hide their corporate sins under the umbrella of their "in name only" major religious affiliation. Such hospitals inflate the cost of the care they provide and then write it off on their taxes. It's a form of cheating the taxpayers, any way you slice it. And, hospitals are supposed to return "in kind" services, which should include the so-called "charity care" you mentioned, in exchange for their preferential tax status, (property/income), in the community. However there is little oversight and few audits of their accounting. Hosting a ladies tea to discuss menopause qualifies as a community service write off. Inflating the cost of providing surgery and medication to indigent patients is written off. The difference between the inflated charges and reimbursement is written off as a loss. Again, this is a form of "charity care" which is actually a subsidy paid by taxpayers to these giant hospital chains.

A majority of physicians, all of the nursing associations that I'm aware of, and an even higher proportion of Americans support single-payer, national health insurance or, (Medicare for All). You have the right to disagree with us, and to continue to fire blanks at the messengers. I have yet to read your counter proposal, which I hope will include a factual response to Nobel prize winning economist Paul Krugman's analysis and support of single-payer health care.

Back to the point made in the commentary posted by jsrRN that started this thread. "Let's stop counting on charity to pay medical bills." We can't and shouldn't rely on "charity" to meet our collective needs for health care. Rose Ann DeMoro's essay on the subject is eloquent.

The question for us as a society is this: Do we want a health care system that makes a few people rich, or one that makes people well?

I love my country.
I truly believe that government of the people, by the people, and for the people can work.

We the people CAN do the right thing.
No, we can't count on "the government" because it is US!

And I don't believe whether a person lives or dies should depend on a pancake breakfast or bake sale while the insurance corporation they have been paying premuims to denies needed care. And pays the CEO millions people paid for HEALTH CARE.

There is no plan to stop charities. The plan is to eliminate the lack of healthcare because charities cannot do it all. Not while the insurance companies make the money and provide ZERO care.

From the original article:

The U.S. is not "incapable" of implementing government mandated, taxpayer funded health care. Its people are unwilling to do so, as evidenced by the lack of support for such initiatives by the majority of our voters and our elected officials.

I have no interest in continuing a discussion in which other posters claim opinions as facts and express disinterest in reading information I have offered to support my viewpoint.

Enjoy your debate.

Memos to Obama: John Geyman on Seizing the Moment for National Health Insurance

By John Geyman, MD
Tikkun magazine
January-February 2009

First off, congratulations to you and your party on your sweeping election results!
Together with a sizable majority of Americans, I am again hopeful for the future of our country.

My special concern, however, is for our failing health care system and how it is pricing health care beyond the reach of ordinary Americans. Our system has come to the point where none of the many incremental reforms will work. The business model of insurance has failed, and we need to rebuild the system on a social insurance model.
Let me be direct.
Although we have many dedicated health professionals, an abundance of the latest technologies, and many fine hospitals, health care has become just another commodity to be bought and sold in a deregulated market based on ability to pay, not medical need.

As you well know, industry profits handsomely from the status quo, raking in money through insurance, pharmaceuticals, medical devices, and so on. Industry has a war chest to defend itself and demonstrates its political power each time any new reform is brought up….

http://www.pnhp.org/news/2009/january/memos_to_obama_john.php

There was also a lack of initiative by many voters initially for things such as civil and gay rights. This proves nothing, and the tide is turning in vast favor of UHC.

http://www.cbsnews.com/stories/2007/...n2528357.shtml

http://www.nytimes.com/2007/03/01/wa...1cnd-poll.html


Please provide evidence of this occuring.

.. no thank you.

All i am asking of you (or any opponent of UHC) is to simply provide evidence of your claims. This is not difficult. You are the ones saying UHC would not work. The burden of proof is on you.

Please remember in the course of this debate to not attack other members personally. I am seeing a bit of it here and wish it were not so. I happen to have strong opinions about this topic as much as anyone, so I understand the passions. But please, no attacking one another.

Whew!! Thank you! As much as I love a good "debate" this was hardly one.

Your right, forget about charity, it is a bad idea. Lets have the government take care of everything.

Who said anything about that?

[
It's immoral to continue to subsidize insurers. Mandates to purchase insurance are wrong because they've failed to control costs and expand coverage every time they've been tried. How much longer will we allow the pain and suffering and death from preventable illness continue when we know there is a solution?[/quote]

Who do you think is going to be doing all the work for Universal Healthcare? The Federal Government is not going to get into the business of being healthcare provider. They don't do it now, CMMS is primarily a policy-making agency for Medicare/Medicaid. The actual hands-on administration is done through outsourcing, like with BCBS. They will do the same for universal healthcare, and will turn to the organizations who are doing the work now. The profits won't be as high, but no one at these insurance companies will starve.