This letter to the editor was published in the November 28, 2003, Wall Street Journal
I was impressed by Lucette Lagnado's "Medical Seizures: Hospitals Try Extreme Measures to Collect Their Overdue Debts" (Oct. 30) and by the Nov. 11 Letters replying to it. Unfortunately the reader might conclude that the real problem relates to how hospitals pursue collections based on a case cited in the article.
That case involved a hospital's seeking arrest warrants when patients repeatedly failed to respond to payment requests and court hearings, or failed to live up to payment commitments. Using numbers cited by the Journal, these "extreme" cases amount to only 0.02% of the total population served by this hospital.
How hospitals pursue collections is not the main issue -- the complexities and costs of administering the U.S. healthcare system is. This fragmented and broken system of charging, billing and collections consumes about 31 cents out of every dollar. Medicare regulations (reported to be more voluminous than the entire IRS tax code), byzantine payment rules, 40-plus million uninsured people, complex payment formulas, and so on, are the real problem. The system works against all of us.
Richard L. Clarke
President and CEO
Healthcare Financial Management Association
Westchester, Ill.