I have found in my conversations with Americans that very few have any understanding of how bad American health care is compared to other industrialized countries. While it’s true that we have great medical professionals, the actual cost to deliver that care is much higher than other similar countries, the outcomes are much worse. Here is a ground level view of a real patient who fled America because of her inability to afford care, and what she found in France.
With a growing number of people being sent to collections here in Jefferson County by JHC, this article points out a very interesting issue of whether the “contract” between a patient (especially one coming into an E.R.) and the hospital is a legal and binding contract for billing purposes. Can you have a binding agreement if the client/consumer doesn’t know the price they are paying when they sign the consent agreement?
Jefferson Healthcare and many other rural hospitals, take advantage of a Federal program called 340B.
As the article states:
This little-known federal program was created to help uninsured or vulnerable patients get access valuable medications regardless of their abilities to pay. This was done by providing certain participating hospitals or safety net clinics with discounted medicines. The 340B program has become an extremely important program for patients in need in this era of unaffordable and unsustainable drug prices.
The article lays out the problems with the 340B program and how some hospitals are abusing it to help themselves remain profitable.
While the point of sharing this article is not to infer that Jefferson Healthcare is in any way one of the ‘bad actors’ in the 340B debate, this article gives the average person a very good quick overview of the controversy. The battle over 340B is playing out in Congress, and it’s outcome will affect JHC. JHC does a great deal charity care, including use of 340B funds, and the program to offer charity care has been recently reformatted to allow people who do not have the means to afford to get needed care. (More on that can be found at the JHC website, JHC Charity Care overview )
I will be looking into the local ramifications of this issue in upcoming months, and should have a more comprehensive overview on them later.
But for now. Here’s a good quote:
For too many hospitals, the 340B program has become a road to profits, not a safety net and not a way to expand charity care for uninsured, indigent patients. For too many patients, particularly those with cancer, the 340B program has not reduced their cost of care 1 cent.
Read the whole opinion piece here:
An expose by the Times of the truly awful business that some lawyers are engaged in.
Over the last number of years, a variety of people have petitioned JHC to look into their practices of charity care along with their collections policies that have resulted in people being sent to court and into bankruptcy over relatively small amounts (some have been larger amounts, to be sure).
Members of the Local 2020 group, Citizens Healthcare Access (CHA) went so far as to go to court to obtain records of collections as the hospital was unwilling to share them with the public (shocking coming from a public hospital).
With citizens groups and some Hospital Commissioners agitating for transparency and better charity care clarity, the hospital finally convened a Patient Financial Experience Task Force, which worked for months in secrecy over their goals. Steve Workman, a citizen activist who often attends the CHA meetings, along with now Hospital Commissioner Bruce McComas were members of the task force.
The new sliding scale has allowed greater flexibility and transparency to low income and no income households. While some online critics are criticizing the program as “too generous” this is being implemented for people who, at these levels, simply do not have a way to pay for services without bankrupting their families. It still allows for the hospital to setup payment schedules for those that may have savings or other financial resources. If they did not have these options, the only other options for these people are simply to not seek care for themselves and their children, leaving them to suffer rather than receive care. (I have talked to single moms working two or three jobs who had to make the choice of putting food on the table or seeking healthcare for their sick children.)
The sliding scale is not new at JHC. But they have expanded and clarified it. The next issue to address is the lack of transparency on pricing. While it’s good to be able to know that even if you can’t afford care you can be worked into the system, the ability to know what you are going to be charged before seeking care is also pretty fundamental to a free and open market. Utimately, the best option is universal healthcare, or some kind of single payers system. We built our interstate systems across the country on the taxes that *all* taxpayers paid. There is a deep and proven set of systems in industrialized countries like ours that do single payer, in fact we are the only ones that don’t. The results do not prove that we are better, our stats prove we are much worse than other countries in the standards of care and longevity. Most people in the US have never even experienced single payer (I have). It’s shocking to see what we have setup and how badly it compares to others, even Canada.
Jefferson Healthcare hospital has implemented a new sliding fee scale for charity care that is helping more families pay for their health care.
“This is currently one of the most generous plans in the state,” said Amy Yaley, spokeswoman for Jefferson Healthcare. “For the people that we are providing health care for, we are definitely making an impact on their financial burden.”
Since starting this blog, I’ve been brought up to date on a number of medical issues here in our town (and on the wider Peninsula). One of the issues is the hospital’s use of collection agencies to go after slow pay patients. It represents a shift from the old notion of ‘charity care’. But who are these people who are being affected by this new approach by the hospital?
This is an story from a real young person struggling to get healthy and get out from under her medical bills. It’s quite illustrative about issues that people here on the Olympic Peninsula are also going through, from what I have heard over the last two months. It raises the issue of whether anything other than a single payer solution can be effective in protecting citizens from medical bankruptcy. I ask that question not because I think I know the answer, but because, given all that is happening in medicine in this country, it should be debated. I would like to reach out and find others, like her, that are here in Jefferson and Clallam county and begin the process of documenting their stories as well. If you would like, we can keep your name anonymous. You can contact me here at the blog.
The debt I accrued from saving my own life means that I can’t go back to college, I can’t own a home, I can’t even get a loan to consolidate my debt.
Abby Norman is a writer. Her work has been featured in The Rumpus, The Establishment, Cosmopolitan, Seventeen Magazine, The Independent, Quartz, Bustle and others.
If you find the article interesting, I recommend you take her hint and send her a paypal for $5 to help pay for a coffee. You would have bought her one if you had gone and heard her story locally at any coffee shop in town.