Question

What do you think about the billing and collection policies of not-for-profit hospitals related to the uninsured? Does this case present an ethical issue? If so, to which party (or parties)? If you could act as the ultimate authority in this situation, what would you do?

Answer 1

According to me the billing and collection policies of not-for-profit hospitals related to the uninsured are definitely unethical. Ideally the hospitals should let the uninsured patients whether they qualify for free or reduced-price care and should charge them fairly but in most cases, this is not done.

According to a survey done for the hospitals of the United States it was found out that :

• Only 42 percent of hospitals notified patients that they could be eligible for charity care before trying to collect unpaid medical bills.
• Only 29 percent said that they charged uninsured and under-insured patients generally the same rate which they charged private insurance and Medicare.
• 1 in 5 Hospitals were reporting patients to credit agencies or placing liens on their properties or garnishing wages, practices that aren't supposed to happen if hospitals are following the rules.
• Only 11 percent of hospitals said they had a conducted a community needs assessment in the past three years to identify pressing health issues in their local community.

All these statistics clearly reflect the lack of ethical practices towards the patients. A large chunk of the uninsured population is constantly worried about getting huge bills if they go to the hospital for their treatment and the hospital management is readily making money from them.

If given an opportunity to be the ultimate authority, I would make sure that hospitals have written policies about charity care so that patients are readily aware about the same. According to the policies the hospitals will not be able to charge uninsured patients more than they charge privately insured or medicare patients if the patients qualify for charity fare treatment. A strict fine shall be imposed on the hospitals if they fail to adhere the policy guidelines and repeated offenders might have their license revoked.