Wednesday, June 3, 2009

Uninsured and Charges

Two items caught my eye today that neatly juxtapose. One is from California, which discusses the publication of hospital charges (retail sticker price) for surgeries, and the hospital's insistence that these prices are meaningless. The other is from a Families USA study counting how many people were without health insurance for some period in 2008.

"That database is meaningless," said Jim Lott of the Hospital Association of Southern California. "There’s no relationship between the price on that list and what your insurance company has negotiated."

OK, fair enough. So how many people *didn't* have insurance, and thereby didn't have the benefit of a negotiated rate?

Turns out in California, during 2007 and 2008, 37.4% of the population under 65 spent some time without health insurance. Of these, 76.9% were without health insurance for six months or more.

80.2% of all people who went without health insurance were members of working families, i.e., someone at the house has a job. i.e., employment does not mean health insurance.

Most interestingly, 26.2% of uninsured people have incomes at or above 200% of the federal poverty level. I would hazard a guess that these folks are not rushing to claim bankruptcy to avoid the bill.

And of course, *all* these people are subject to the meaningless numbers. They all are charged sticker price. Maybe they don't pay them, but someone does, either through direct write-offs which impact us at the local tax level (we pay it for them) or indirectly through these folks becoming indigent.

Sticker prices hurt all of us. They are not meaningless. I myself have been charged them, even with my PPO in place.

I, like many other folk in public reporting, would prefer to report the cost of care - how much it costs a hospital to perform a given procedure - but this data is still hidden from us.

In the meantime, and even if I were to have cost data in hand, I would still publish charges, because charges most certainly do mean something, and they mean something to an ever-growing portion of the population.


Michael Hickins said...

Gotta love it when you can't get basic information like how much something costs. How much is that car? Not important.

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