| If you've ever felt aghast looking over a
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| | uninsured patients less, but the results
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| hospital bill -- somehow sure the numbers
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| | have yet to be seen. Some question
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| couldn't possibly be right -- you're not
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| | whether the recommendations are applied
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| the only one. According to a 2004 study,
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| | at all by most of the hospitals,
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| published by the journal Health Affairs,
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| | including those in Texas, and the fact
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| those lacking health insurance are
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| | it's not mandatory is a problem.
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| charged an average of 2.57 times more by
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| | Gerard Anderson, director of the Center
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| U.S. hospitals than those with insurance,
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| | for Hospital Finance and Management at
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| a discrepancy that has been steadily
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| | Johns Hopkins University's School of
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| increasing since 1984.
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| | Public Health -- and study author -- has
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| Texas is no exception. In fact, residents
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| | served as an advisor for several lawsuits
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| of Dallas, Houston, and the rest of the
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| | already. He encourages advocacy groups to
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| state are more likely to be uninsured
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| | move forward with legal action. "The
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| than the average American, as just over
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| | mark-up on hospital care for these
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| 25% of Texans lack coverage. In some
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| | individuals, especially for those who can
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| areas of the state, it's closer to one in
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| | afford it least, is unjustifiable," said
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| three, and that doesn't include those
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| | Anderson.
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| considered under-insured, or those
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| | The highest discrepancy was found in the
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| insured by government programs.
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| | amount for-profit hospitals charged,
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| Like many in Texas, a good percentage of
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| | versus estimated costs by Medicare. This
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| uninsured Americans are working
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| | all makes slightly more sense after
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| individuals who can generally support
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| | learning that, generally, hospitals in
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| themselves and their families, but who
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| | the association determine costs by a list
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| cannot afford to keep pace with the
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| | called the chargemaster, which is,
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| rising cost of health care. Health
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| | technically, the same for everyone.
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| insurance premiums have increased an
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| | Insurance companies then negotiate with
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| average of 15% over the last five years,
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| | hospitals on behalf of their clients to
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| more than triple the inflation rate.
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| | reduce these charges. It is widely
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| One-third of companies did not offer
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| | believed hospitals, as many other
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| coverage in 2004, and even when it was
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| | businesses would, however, greatly
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| offered, there was no guarantee that
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| | inflate initial costs in anticipation of
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| employees could afford the premiums.
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| | this negotiation.
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| "That's me exactly," said Anne, a 27
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| | "When a hospital presents a bill that has
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| year-old city employee in Kansas City,
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| | charges on it, those charges are the same
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| Missouri. "I couldn't afford the premium,
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| | for everyone. What is different is how
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| so I had to get this low-cost,
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| | much insurers may negotiate in terms of
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| ridiculously low-coverage plan that will
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| | discounts with hospitals," Amber Coyle,
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| basically only help me if I get in a car
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| | AHA policy analyst said.
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| wreck."
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| | The American Hospital Association also
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| Employee spending on health care
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| | claims the research is inaccurate, that
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| increased an average of 143% between 2000
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| | it is out-of-date and methodologically
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| and 2005. It does not seem a coincidence,
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| | flawed. Hospitals needed the U.S. Centers
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| then, that rates for the uninsured have
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| | for Medicare and Medicaid guidance to
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| also jumped the most since 2000. The
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| | institute discounts for the uninsured,
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| problem is further exacerbated by what
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| | said AHA, which did not exist when the
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| has become a cyclical predicament,
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| | study was conducted.
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| particularly in cities like Dallas and
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| | The claim is that hospitals were unsure
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| Houston: uninsured residents of rural
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| | if they could charge different patients
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| areas, where there is lower quality care
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| | different amounts before this guidance,
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| and less access to financial aid
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| | but many advocates contend it does not
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| programs, travel to the city for their
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| | take bureaucratic policy to know that
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| medical needs, which can then be covered
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| | charging those who are financially less
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| by hospital or county programs. This, in
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| | capable of paying more is simply wrong
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| turn, drives up the average charge of any
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| | and counterproductive.
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| given service provided by those
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| | The only issue opposing groups seem to
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| hospitals, which contributes to increased
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| | agree on is that increasing the number of
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| costs for health insurance companies,
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| | those with coverage would dramatically
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| which then raises premiums.
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| | deflate the situation. This could be done
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| What all this translates into,
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| | by extending government programs,
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| unfortunately, is even higher bills for
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| | including Medicaid -- which is currently
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| those who are barely getting by as it is
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| | experiencing drastic cuts and instituting
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| if something does happen.
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| | more affordable private health insurance
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| Sound unfair? Advocacy groups think so
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| | policies. Either way, until then (or "if
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| too. More than 60 class-action lawsuits
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| | then"), keep yourself healthy, whether or
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| have been filed over the issue. In
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| | not you're insured.
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| response, the American Hospital
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| | What affects your health also will
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| Association (AHA) has instituted a
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| | eventually affect your bank account.
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| voluntary policy to charge poor and
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