The New Health Dialogue

As we've said before, the cost of doing nothing on health reform means decreasing coverage and increasing costs to families, businesses, and providers. Today, the New York Times reminds us of the cost of doing nothing for America's hospitals. Hospitals face an uphill battle trying to stay financially viable and at the same time, provide quality, affordable care to patients who are underinsured or uninsured.

Hospitals are required by law to stabilize patients who come into the emergency room seeking urgent care. Who pays for that care is a more complicated question. Insurers can deny claims for patients with inadequate health coverage, and uninsured patients can rack up bills that will drive them into bankruptcy from just one costly ER visit. Though not required by law, some hospitals choose to provide additional care after stabilizing a patient. According to the Times, this charity care, along with other unpaid care costs and money that can't be collected from patients came to about $36 billion in 2008.

Park Nicollet Health Services in Minnesota has been forced to lay off hundreds of employees as they struggle to keep up with rising costs. Park Nicollet was left with $29 million in uncompensated care costs in 2007.That number shot up to $43 million in 2008. The Times reports:

For hospitals, unpaid bills can stem from uninsured patients like a man who recently showed up at Park Nicollet’s emergency room in withdrawal from alcohol. Besides needing emergency heart surgery, the patient was treated for respiratory failure and alcoholic hepatitis, which involved a five-day stay in the intensive care unit. His care ended up costing $85,000, which the hospital has little hope of recovering.

And it's not going to get any easier -- without comprehensive health reform, which will cover more than 30 million uninsured Americans, the number of uninsured will likely surpass 53 million (at best) or 58 million (at worst) over the next 10 years. Costs will also climb under the status quo. For example, Anthem Blue Cross, the largest insurer in California recently announced a 39 percent increase in premiums. Administration officials, up to and including, HHS Secretary Kathleen Sebelius are calling on Anthem to justify this drastic increase. Unfortunately, similar rate hikes could become commonplace in the coming years without health reform. Unless we act now, middle class Americans will become increasingly unable to afford care, and hospitals will become less able to provide care without going bankrupt.