Richard L. Clarke, DHA, FHFMA
President and CEO, HFMA
This weekend’s “60 Minutes” segment “Hospitals: Is the Price Right?” raised a subject that hospital leaders care deeply about: providing care to all members of their communities. Unfortunately, while the broad subject is the right one, the focus is misleading.
The broadcast led with an account of a middle-income family that, because of the high cost of health insurance, decided not to carry coverage. After a bad accident and resulting emergency and rehabilitative care, the family was hit with a very large hospital bill. K.B. Forbes, who runs a Latino group that focuses on hospital billing practices, responded to the situation this way: “Basically, hospitals charge uninsured people four or five times more than what they would accept as payment in full from an insurance company. Simply put, it’s price-gouging.”
Sen. Charles Grassley, R-Iowa, commented that hospitals have an institutional bias against uninsured people. He also said that if hospitals don’t make changes, “we’ll probably be doing some legislating in that area.”
Forbes, Grassley, and the Bush Administration all are circling around the problem, but not hitting its true cause: how do we, as the richest economy in the world, allow more than 45 million Americans to go without health insurance? Let’s deal head on with the problem of access to affordable health insurance. High-deductible health plans alone will not solve this problem. Hospitals do have a role to play. Hospitals can do a better job of pricing. They can develop effective methods of identifying the financial capabilities of uninsured or underinsured persons. They can renegotiate their managed care contracts to attempt to rebase their pricing. They can develop rational pricing philosophies that can stand public scrutiny. HFMA offers tools to support all these important actions.
But to address the root causes of this problem, we need broader action. We need a major public/private partnership dedicated to solving the problem of the uninsured. We need a national focus similar to the focus on universal adoption of electronic health records--an initiative led by a respected individual. We need stretch goals for this public/private initiative to work toward. Simply put, we need action that targets the real problem.
