Robert FrombergEditor in Chief, HFMA
Yesterday over breakfast I read an Associated Press article that told the story of several patients nearing the end of life who faced sticker shock over the cost of expensive treatment that would prolong their lives but that was not covered by insurance. Some of the patients said no to the treatment.
The article raises huge issues about cost and coverage, but first check out the way the article portrayed how one patient learned about the high cost of this treatment:
She was waiting for her second treatment…when someone from the business office marched in. Her share, she was told, would cost more than $18,000, since the drug wasn't insured for her type of cancer.
“Someone from the business office marched in.” Marched? Now where did that come from? Well, no matter. Whether it was the reality or the reporter embellishing or the patient’s perception, this image is a reminder of the way people view those at hospitals who bear information about cost and payment. What a great example of why the PATIENT FRIENDLY BILLING® tools for improving financial communication are crucial.
The larger issue, of course, is healthcare costs. The debate on this point often sidesteps the painful issue of the finite nature of healthcare resources. The article quotes Harlan Krumholz, M.D., of Yale University as saying, "People still have an underlying belief that there's an infinite amount of resources that can be invested in healthcare. But I think we're coming to a realization that we're going to need to confront these issues." Does anyone remember when Richard Lamm, former governor of Colorado, spoke about the so-called rationing of care? The response: he wasn’t in office much longer. Anyone interested in this issue should read an article Governor Lamm wrote in hfm magazine a few years ago called “Who Is Entitled to What?” in which he writes, "We cannot provide unlimited, unrestricted health care if we are paying limited taxes and insurance premiums."
So there we have it—in one short AP article, the range of challenges in the business of caring, from the way in which one business office person talks to one patient to the need to figure out a way to determine how many healthcare resources should be devoted to which patients. Whew.
Remember Me
