March 16, 2009

Insult to Injury: How Hospitals Hustle the Uninsured

Hospitals are charging self-pay patients two, three, and four times what they accept as full payment from insurance companies, simply because they can.

Medical debt saddled 72 million adults in 2007 and caused HALF of all personal bankruptcies in 2005. With the recent surge in jobless claims the number of uninsured and under insured self-pay patients is steadily rising and hospital ERs are seeing more patients seeking primary care. Those whose income disqualifies them from community assistance programs even by a hair may face unfathomable costs for their stay at the hospital. While insurance companies fork over a reasonable amount over the actual cost of care to the hospital and Medicare even less, people who can least afford to pay are charged the most. A procedure that may cost the hospital $6,000 would retail to the insurance companies for $8,000 and to a self-pay patient for $12,000! Talk about kickin’ ‘em when they’re down!! And it’s all legal.

A typical hospital bill for a self pay patient is conjured in a black mass, resulting in an indecipherable and meaningless arbitrary assignment of questionable charges to questionable procedures such as $127 disposable mucous recovery systems (tissues) and miraculous births by men who happened to be having heart surgery at the same time. The actual costs of all these procedures are unknown to anyone but the hospital and so we are at the mercy of their discretion.

They deliberately mystify the billing process, assuming that patients will not ask questions or be too intimidated by bureaucracy to pick a fight. And they’ve only become more aggressive in squeezing blood from stones. Hospitals have recently begun turning collection over to credit companies straight off the bat who charge high interest rates and ruin credit ratings.

So what’s been done about it? In 2005, an investigation was held by the Senate Finance Committee led by Senator Chuck Grassley to address alleged price-gouging of self-pay patients, including the uninsured and under insured, by US hospitals. The hospitals responded smugly as they admitted to unfair billing practices.

It’s now 2009 and hospitals are still charging a literal arm and leg for their services with full-frontal legality. Nothing has been done by our government to force hospitals to stop gouging self-pay patients aside from a few states that have entered into voluntary agreements with hospitals to make price lists available to the public and anecdotal court victories. For an industry that is known to inflate its actual costs by BILLIONS of dollars every year, this doesn’t seem like much of a challenge.

Who’s still fighting? At the frontline is activist KB Forbes, founder of Consejo de Latinos Unidos, an advocacy organization whose cause célèbre is transparency in hospital billing policies. Mr. Forbes’ organization was instrumental in getting Congress’ attention on the matter, but unfortunately, every substantial Congressional bill proposed addressing hospital price gouging has been struck down.

If you are being taken for a ride by your hospital’s billing department, you can find great resources on KB's websites to fight hospital price gouging and volunteer time or money to force the government to stop this institutional injustice!

For more information:,

This post was written by Leah Bush, a freelance writer, volunteer blogger for the Literacy ‘n’ Poverty Project, and aspiring Guru whose past involvement includes the American Red Cross Hurricane Katrina Recovery Project and volunteerism in Honduras and the Dominican Republic. Questions regarding this post may be forwarded to

1 comment:

Chanelle Carver said...

Nice post, Leah. Hopefully we'll see some change in this area soon. All parts of our government, generally speaking, seem to be on the same page as far as healthcare reform. I guess on the same page as far as the when, which is NOW, but not the what, how or for whom.

Then again, even I don't know exactly how it's supposed to happen but it's also not my field...I think we should give it a few months or maybe a year or two to see some real change take place in the health industry.

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