Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

Land where calling an ambulance is first step to bankruptcy
The Guardian | 4th November 2003 | Julian Borger

Posted on 11/05/2003 3:15:59 PM PST by Taff

The second in a three-part series on Bush's America looks at the inflated hospital bills facing the uninsured poor

Julian Borger Tuesday November 4, 2003 The Guardian

Rose Shaffer's heart attack taught her a lot of things that, as a nurse, she should have known. She learnt it pays to eat carefully and exercise regularly. And she learnt the hard way that if you cannot afford medical insurance in America, you better hope you don't get sick. A Chicago hospital saved Mrs Shaffer's life but she feels it is now trying to take it back. Since that frantic October night three years ago, the hospital owners, a Christian, non-profit foundation, have hounded her for crushing bills she could not afford, partly because as an uninsured patient she had been charged double.

The hospital sent debt collectors after her who called her all hours of the night, at home and work, until she gave in and was forced into bankruptcy. Now, at the age most people are thinking of retiring, she has to work long hours seven days a week at a nursing agency for the next three years to have any hope of holding on to her last asset, a suburban bungalow.

"When I was young I thought that, when you reach 60, if you don't have anything, then you're nothing. Well, I'm 63 and I don't have nothing, and I'm not going to get anything," Mrs Shaffer said, sitting at her kitchen table sifting through some of her latest bills.

"The whole system is messed up. In this country the rich get richer and the poor get poorer, and no matter how much you work, you're going to get poorer."

In the US today, there are nearly 44 million people in her position - without medical insurance in a country that does not guarantee basic healthcare - and the crisis is deepening. In the three years since George Bush took office, the ranks of the uninsured have risen by 10%, or four million people. The government will pay if you are destitute but not if you earn enough to keep above the poverty line - about $18,000 (£10,600) for a family of four. In theory, employers are supposed to provide health insurance but more opt not to, and buying cover individually is either very expensive or impossible if you have a "pre-existing condition".

Consequently, 15% of the population, most of them the working poor, live in the fear that an accident or sudden illness could plunge them into debt. The uninsured will typically put off going to see a doctor in the hope that their medical problems will pass. They tend to seek treatment only when their condition is critical.

Almost everyone in US politics, including all the candidates in the presidential campaign, agree the situation is unacceptable but differ widely on how to fix it. A succession of presidents, from Harry Truman more than half a century ago to Bill Clinton in 1993, have floated grand schemes for achieving universal healthcare coverage, but each time they have been defeated by resistance from the medical profession, employers and the tax-averse.

"I think the problem is the extent of income redistribution it would take to make it happen," said Karen Davis, the head of the Commonwealth Fund, an independent health and social policy foundation. "The greatest sentiment for change comes when the economy is bad, but that's also when resources are at their shortest."

There are public hospitals across America, but their size and number are tiny compared to the scale of the problem. Chicago has Cook County hospital which is overwhelmed in most departments by the sheer volume of needy patients. But it does have a world class emergency room and excellent trauma specialists.

Rose Shaffer, however, did not have the good fortune to suffer her heart attack near the Cook County ER. The ambulance did what it was supposed to - take her to the nearest trauma centre, at South Suburban hospital, part of a Lutheran-run chain called Advocate Health Care. Two days later, she was transferred to another Advocate hospital, Christ medical centre.

Charity

Christ's is the biggest hospital in its region, and its illuminated cross soars over Chicago's southern suburbs like a beacon - a vivid symbol of what President Bush calls faith-based charity. As a non-profit organisation Christ's is supposed to offer care to the needy, but there is no state requirement for just how much charity it should mete out. Mrs Shaffer said that when she was recovering from her heart attack, a hospital official told her she would be sent application forms for charity assistance. They never came. Instead, she received a bill for $18,000 - $6,000 for each day she spent at Christ's.

According to the Service Employees International Union (SEIU) which has investigated Advocate and other "charitable" hospitals in the Chicago area, Mrs Shaffer's bill would only have been $8,500 if she had been insured. Medical insurance firms typically negotiate heavily discounted rates for clients. The uninsured have no such leverage, and according to SEIU's hospital accountability project, end up paying on average 139% more than the insured. Joseph Geevarghese, the project director, said: "When these people go to hospital they lose their home." The hospitals often see the uninsured ("self-pay" in the jargon) as a profit opportunity. In the words of an industry consultant, Michael Zimmerman, "self-pay now stands alone as the financial category that will provide the biggest bank for the buck".

"It can and should be a cash cow for the hospitals, but it is not," Mr Zimmerman wrote in a newsletter for hospital administrators. He argues hospitals are not being tough enough when it comes to debt collection from patients.

Mrs Shaffer said there was no lack of enthusiasm in her hospital's pursuit of her money. "The collection people were real nasty," she complained. "They'd call on Sunday, they'd call at 9 o'clock at night. They'd call on the job. My voicemail was full. It was harassment."

Advocate says it is no more aggressive than any other hospital. In fact, according to Ed Domansky, a chain spokesman, the hospital is obliged by federal law to make "reasonable efforts" to collect debts, and to maintain a uniform price structure, which does not allow giving automatic discretionary discounts to the uninsured. The SEIU, he said, was picking on Advocate hospital because it was seeking to organise its workers, and he pointed out the chain had recently expanded its charity care, and made more effort to inform the uninsured about its availability.

"This is not just an issue in one hospital or one state," Mr Domansky said. "We believe the federal regulations on hospital billing make the plight of the uninsured worse, and we would welcome change."

Deep trouble

It is not just the uninsured who can end up impoverished. Richard Roche thought he had insurance. His employer, a cab company, did not provide it, so he paid more than $400 a month for his own policy. When he had to have a growth removed from his windpipe, his insurer agreed to pay only a fraction of the cost. The hospital went after him rather than the insurer and the bills eventually forced the 61-year-old into bankruptcy. He had to sell his house and cashed in his life insurance. "They got me. Once you get sick - that's it. You're in deep trouble."

Ronald Pollack, the head of a Washington pressure group, Families USA, said: "This problem reaches deeper and deeper into middle class and working families. For most Americans it has gone from an issue of altruism for a discrete, disadvantaged population, to an issue of self-interest."

The crisis has become an issue in the presidential campaign. Remedies vary in cost and ambition, from schemes to expand Medicaid and Medicare (the government-funded schemes for the destitute and elderly) to cover the rest of the uninsured, financed by repealing the Bush administration's tax cuts, to the far more modest market-oriented proposals put forward by the White House itself, based on tax breaks for the self-insured.

History suggests that, whoever is elected, little will change. The hospital business and the $400bn insurance industry have too much to lose, as do corporate employers who would be asked to foot much of the bill.

Much like an uninsured patient, the US knows there is something wrong, but it is unable so far to face the cost of the cure.


TOPICS: Business/Economy; Culture/Society; Government
KEYWORDS: breachbirthanoxia; bush; health; ozonealert; poverty; sandwichshyofpicnic; syphilliticdementia; takeyourmeds; troll; usa
Navigation: use the links below to view more comments.
first previous 1-5051-83 last
To: snopercod
My daughter had an endoscopy done this summer. The hospital bills keep rolling in, and I refuse to pay the $10 a month... paying hundreds of dollars a month, instead. The bills will be paid off by December, come hell or high water. Paying the 20% in out-of-pocket costs is a real strain. But, not paying the bill isn't an option. Should my daughter need additional care, it is imperative that she be seen by a doctor and a hospital that are well respected in the medical community. I am paying for their services, after all.
51 posted on 11/06/2003 5:34:44 AM PST by Pan_Yans Wife (You may forget the one with whom you have laughed, but never the one with whom you have wept.)
[ Post Reply | Private Reply | To 19 | View Replies]

To: Capriole
Most people confronted with overwhelming bills seem to Just Say No to the hospital. I would only urge them to pay their separate doctors' bills, because the truth is that most doctors, like our own Strongbow, are doing too much charity work as it is.

I don't understand this. As I state in another post on this thread, my daughter had an endoscopy, and we have the bills. I am paying, of course, what I can afford, but at an accelerated level, not $10 a month. I am paying off the 20% charge, by paying hundreds of dollars a month toward the bills. They will be paid off shortly. This is a hardship, only because we are a typical American family with two children, and all of the costs and responsibilities involved.

If I take my car to the mechanic for repair, and owe the mechanic $1500, I would pay him, most certainly, for a car is a necessity. Why would I see this differently when it comes to my daughter's medical care? She is more important than transportation, after all.

Why is it that so many people ignore their bills, and do not feel obligated? Don't they realize that receiving the best medical care is a luxury that we cannot afford to lose? By paying our share of the costs, we are doing the right thing. However, we will pay for it in the future, with higher costs passed along to us. This is not fair.

But life is not fair.

52 posted on 11/06/2003 5:47:19 AM PST by Pan_Yans Wife (You may forget the one with whom you have laughed, but never the one with whom you have wept.)
[ Post Reply | Private Reply | To 35 | View Replies]

To: Pan_Yans Wife
The difference, of course, is that you are an honorable person and pay your debts.

Other people look at the matter in a different manner. They pay the mechanic because they recognize that he is a small businessman with a family to support, just like them. They also know that they'll end up in small claims court if they don't pay him. But they are aware that the hospital ignores millions of dollars owed it by illegal immigrants, indigents, and the elderly (and many of those elderly, BTW, are fairly prosperous but still don't pay the full fare because they have Medicare). These people wonder why they should pay when no one else seems to.

I'm not saying this is right. I'm saying that this is the rationale.

And let's be frank. While some of those who walk away from their debts have been restored to health and could well pay, others don't pay becuase the illness that brought them into the hospital is still with them and they can't work, or can just barely support themselves.

53 posted on 11/06/2003 6:28:07 AM PST by Capriole (Foi vainquera)
[ Post Reply | Private Reply | To 52 | View Replies]

To: Taff; meowmeow; Constitution Day; 4mycountry; Poohbah; Grampa Dave; an amused spectator; ctlpdad; ..
I love the smell of ozone in the morning. Somehow, I don't think Taff will be with us in FReeperland for long.

Incoming!

54 posted on 11/06/2003 6:29:18 AM PST by VRWCmember (We apologise for the fault in the taglines. Those responsible have been sacked.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Taff
It is remarkable that Bush could create this crisis in such a short time. I'm glad you pointed it out. Take these little poems back to DU with you. Yall can use it as an anthem.

Solar Flair

We best be careful til this thing,
Has run it’s natural course.
My tinfoil hat could not withstand,
The power of this force.
It bombed my brain just like a nuke,
The functioning was gone.
I thought I was a Liberal,
I felt so all alone.
But praise the Lord it went away,
And I am back to normal.
Those solar flares can sure do harm,
Your brain will be a doornail.
So please be careful when you’re out,
I’ll tell where I’m at.
Until this solar storm is gone,
I’ll wear a double hat.

Flurry 10/31/03

I wrote this poem will under the effects of solar flare. 98% brain function loss

The Liberal Slant

The planes on nine eleven,
Were piloted by him.
The first Gulf War and Viet Nam,
He’s to blame for them.
Korea and sure World War Two,
Once again his fault.
And in there too, Geraldo found,
He looted Capone’s Vault.
Extinction of the dinosaurs,
And yes the Big Bang too.
George Dubaya Bush, he did it all,
And he blames me and you.

Flurry 10/30/03
55 posted on 11/06/2003 6:36:59 AM PST by Conspiracy Guy (Living fast is fine as long as you steer well and have good brakes.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: VRWCmember
Taff has the rank odor of socialist troll trying troll on Free Republic.

It appears that Troll Zotting is in order.

Anyone who posts the anti GW crap from the Guardian should be zotted and banned from posting for 1 calendar year or 1 century depending on how Jim and the Moderator feel.
56 posted on 11/06/2003 6:39:13 AM PST by Grampa Dave ("If you don't like change, you're going to like irrelevance even less.")
[ Post Reply | Private Reply | To 54 | View Replies]

To: Grampa Dave
amen. and amen.
57 posted on 11/06/2003 6:53:14 AM PST by glock rocks (molon labe)
[ Post Reply | Private Reply | To 56 | View Replies]

To: glock rocks
Whenever, I see an article posted from the Guardian posted on FR, I automatically think "Here is some Guardian BS posted by a troll or a pseudo conservative, who should be outed as a troll!"
58 posted on 11/06/2003 6:56:55 AM PST by Grampa Dave ("If you don't like change, you're going to like irrelevance even less.")
[ Post Reply | Private Reply | To 57 | View Replies]

To: VRWCmember

Taffy pull, anyone?

59 posted on 11/06/2003 6:59:16 AM PST by glock rocks (molon labe)
[ Post Reply | Private Reply | To 54 | View Replies]

To: Grampa Dave
got to Taff's profile page and look at the "in forum" posting history.
60 posted on 11/06/2003 7:00:20 AM PST by glock rocks (molon labe)
[ Post Reply | Private Reply | To 58 | View Replies]

To: glock rocks
If Taff is over here on a Visa, it should be rescinded and then send his socialist a$$ back to the UK.
61 posted on 11/06/2003 7:06:49 AM PST by Grampa Dave ("If you don't like change, you're going to like irrelevance even less.")
[ Post Reply | Private Reply | To 60 | View Replies]

To: Taff; vwrcmember

"Dang, Sundance, do you think you may have used too much powder on that ZOT?"

62 posted on 11/06/2003 7:11:03 AM PST by Jonah Hex (If a dog started to salivate, would Pavlov ring a bell?)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Capriole
"The insurance company is getting a volume discount. It sends all its customers--er, that is, patients--to some designated hospital(s). In exchange the hospital charges the insurance company slightly less. Perfectly normal capitalist business practice"

It's more than a volume discount. There is not any difference in the cost of providing care to an insurance patient than a non-insured patient.

The only difference is marketing costs. And there's not that much difference their either. In fact most people decide who to go to based on word of mouth, rather than insurance companies. The only way insurance companies are able to direct patients to doctors is by limiting the patient's choice.

There is no way that difference is justified by volume. But it occurs in part because of the way insurance companies negotiate. And the difference is also exaggerated by the way we make up for indigent care.

Volume discounts don't normally drive the price below the incremental cost of providing care (without fixed costs). But the difference between fully loaded costs and incremental costs are larger because fully loaded must absorb the cost of indigent care.

63 posted on 11/06/2003 7:28:42 AM PST by DannyTN
[ Post Reply | Private Reply | To 31 | View Replies]

To: friendly; JohnHuang2
Ping for quote of the day material
64 posted on 11/06/2003 7:45:14 AM PST by Fierce Allegiance (Government money = government control)
[ Post Reply | Private Reply | To 15 | View Replies]

To: spunkets
"A nurse has med insurance as part of her employment, unless she was unemployed"

She was 63. She was probably either retired or working part-time. And not every nurse works for a hospital that offers insurance.

In case you haven't noticed, there are a lot of small business who are being priced out of the health insurance market. Group insurance is twice as high as individual insurance. So it's cheaper just to pay your employees a little bit more and tell them to get their own insurance.

65 posted on 11/06/2003 7:56:25 AM PST by DannyTN
[ Post Reply | Private Reply | To 29 | View Replies]

To: VRWCmember
Thanks, enjoyed the thread. LOL
66 posted on 11/06/2003 8:00:58 AM PST by tioga (freedom rules today!)
[ Post Reply | Private Reply | To 54 | View Replies]

To: Grampa Dave; Admin Moderator
The key words on this post (BUSH; HEALTH; POVERTY; USA) are almost identical to the keywords posted on Taff's last article posted:

"BUSH; FOOD; POVERTY; TAKEYOURMEDS; TROLL; USA;" Long queue at drive-in soup kitchen

So far Taff has been a hit an run poster who appears to have an agenda other than comment and debate.

67 posted on 11/06/2003 8:07:57 AM PST by Rebelbase
[ Post Reply | Private Reply | To 56 | View Replies]

To: Taff
#67 is for you too.
68 posted on 11/06/2003 8:08:45 AM PST by Rebelbase
[ Post Reply | Private Reply | To 67 | View Replies]

To: VRWCmember; Taff
In the US today, there are nearly 44 million people in her position - without medical insurance in a country that does not guarantee basic healthcare - and the crisis is deepening. In the three years since George Bush took office, the ranks of the uninsured have risen by 10%, or four million people.

It's all Bush's fault !! ...
< /sarcasm >

BOTH of those on THIS thread


69 posted on 11/06/2003 8:16:42 AM PST by MeekOneGOP (Check out the Texas Chicken D 'RATS!: http://www.freerepublic.com/focus/news/keyword/Redistricting)
[ Post Reply | Private Reply | To 54 | View Replies]

To: glock rocks; Taff; VRWCmember; yall
I guess he had to post and run ?? ...

Find In Forum: Taff


70 posted on 11/06/2003 8:25:48 AM PST by MeekOneGOP (Check out the Texas Chicken D 'RATS!: http://www.freerepublic.com/focus/news/keyword/Redistricting)
[ Post Reply | Private Reply | To 23 | View Replies]

To: Rebelbase; glock rocks
Thanks for your followup re Taff and his postings.

Glock Rocks has nailed him like you have.

What a sorry life these Trolls live.
71 posted on 11/06/2003 8:27:06 AM PST by Grampa Dave ("If you don't like change, you're going to like irrelevance even less.")
[ Post Reply | Private Reply | To 67 | View Replies]

To: DannyTN
"Group insurance is twice as high as individual insurance."

Unless it's changed in the last couple years, it's the other way around. Groups are given discounted premiums, because of the volume and lower admin. cost. Small business is priced out, because their group membership is low. THey have the option of pooling with other business though. Ultimately the insurance itself is expensive, for various reasons. There are also fed and state tax considerations for the business when calculating cost. Paying the employees a little more really isn't going to cover the cost of any insurance.

"She was 63...

She was a nurse in an area that pays very well. What did she do with all that cash she earned over the years? Retired, she has medicare. At any rate the story is completely bogus and well beyond any reasonable exaggeration.

72 posted on 11/06/2003 8:33:14 AM PST by spunkets
[ Post Reply | Private Reply | To 65 | View Replies]

To: spunkets
Unless it's changed in the last couple years, it's the other way around.

I checked them 3 years ago and recently. Both times individual was less than half the price of group. Group must accept preexisting conditions. Individual insurance can still deny you unless you are completely healthy. That more than offsets any volume discount.

She was a nurse in an area that pays very well. What did she do with all that cash she earned over the years?

Nurses used to make squat. The rates have only shot up in the last couple of years. Medicare doesn't kick in until 65.

I don't think it's bogus at all. You do get charged double if you don't have insurance.

73 posted on 11/06/2003 8:41:27 AM PST by DannyTN
[ Post Reply | Private Reply | To 72 | View Replies]

To: glock rocks
My guess is troll... but he did respond to one post on another thread. It gives a good idea where he stands:

To: Cdnexpat

I worked with a Brit that said that anyone who can afford it has bought medical insurance. He had an infected tonail and asked the National Health Service for an appointment. They told him it would be 6 weeks to get an appointment! He used his insurance and got treated that day.


11 posted on 08/15/2003 9:12 PM PDT by Wacka
[ Post Reply | Private Reply | To 3 | View Replies | Report Abuse ]




To: Wacka

Then that Brit was lying to you - naughty little Brit.


12 posted on 10/09/2003 5:48 AM PDT by Taff
[ Post Reply | Private Reply | To 11 | View Replies | Report Abuse ]

74 posted on 11/06/2003 8:41:55 AM PST by Nick Koss
[ Post Reply | Private Reply | To 21 | View Replies]

To: DannyTN
"Group must accept preexisting conditions. Individual insurance can still deny you unless you are completely healthy."

That depends on the state. The last time I looked over insurance premiums for IL and WI. Groups were always significantly cheaper. Individual, or family plans would only come close at best, but were always higher w/o exception. When preexisting conditions were allowed to be excluded from coverage, the situation was the same.

"Nurses used to make squat."

She worked in a high paying area. It's been that way for many decades. Unless she was a lifelong candy striper.

"Medicare doesn't kick in until 65.

Yes, she may be young enough to put her to 65. Still the story is completely bogus, as per my first 2 posts.

"Both times individual was less than half the price of group."

This doesn't even make sense. The admin costs alone to handle individual accts and the agents cut make it ridiculous. Any company would automatically buy individual plans, instead of group plans.

75 posted on 11/06/2003 8:57:25 AM PST by spunkets
[ Post Reply | Private Reply | To 73 | View Replies]

To: DannyTN
"You do get charged double if you don't have insurance."

Not up here. The price is the same, unless the price is discounted, because the patient's in a PPO, or it's an HMO.

76 posted on 11/06/2003 9:00:27 AM PST by spunkets
[ Post Reply | Private Reply | To 73 | View Replies]

To: spunkets
"Not up here. The price is the same, unless the price is discounted, because the patient's in a PPO, or it's an HMO.

Duh! One group getting a discount of 50% is exactly the same think as another group paying double. It's just semantics.

77 posted on 11/06/2003 9:21:40 AM PST by DannyTN
[ Post Reply | Private Reply | To 76 | View Replies]

To: spunkets
Post #29: Excellent research on this steaming pile of feces, euro-trash hit piece.
78 posted on 11/06/2003 9:33:55 AM PST by friendly (Man is so made that whenever anything fires his soul, impossibilities vanish.)
[ Post Reply | Private Reply | To 29 | View Replies]

To: DannyTN
"Duh! One group getting a discount of 50% is exactly the same think as another group paying double. It's just semantics. "

Sure it is, but you have it the price the groups are being charged backwards. The group that consists of individual heath care plans pays more, than the group whose members are covered under the single group plan.

79 posted on 11/06/2003 10:09:28 AM PST by spunkets
[ Post Reply | Private Reply | To 77 | View Replies]

To: Taff
A succession of presidents, ... Bill Clinton in 1993, have floated grand schemes for achieving universal healthcare coverage, but each time they have been defeated by resistance from the medical profession, employers and the tax-averse.
What credibility should one give to an article that includes scuh lies ?
80 posted on 11/06/2003 12:07:06 PM PST by Truth666
[ Post Reply | Private Reply | To 1 | View Replies]

To: Taff
no matter how much you work, you're going to get poorer

Load 16 tons and what do you get? Another day older and deeper in debt.

OTOH, does anybody owe you anything just because you are a citizen? You have a right to vote and a right to an education. You also have the same opportunity anybody else does. America the Land of Opportunity. Don't take the opportunity, don't expect much when you are 63. How were yur grades in school? What was your college major? Any advanced degrees? For many, a college degree is their main opportunity.

81 posted on 11/06/2003 12:15:41 PM PST by RightWhale (Close your tag lines)
[ Post Reply | Private Reply | To 1 | View Replies]

To: Nick Koss
Taff - nobody by that name.
82 posted on 11/06/2003 2:19:06 PM PST by glock rocks (molon labe)
[ Post Reply | Private Reply | To 74 | View Replies]

To: oh8eleven
it's past time for your reality check. When you loose your job that has a group policy, and because of prior health problems, are deemed ineligleable for an individual policy, that cold, hard, reality will come creeping in.
83 posted on 11/06/2003 11:37:05 PM PST by rightofrush (right of Rush, and Buchanan too.)
[ Post Reply | Private Reply | To 50 | View Replies]


Navigation: use the links below to view more comments.
first previous 1-5051-83 last

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson