In an incredibly biased piece, Jonathan Cohn writes about the problems some non-profit hospitals have in fulfilling their charity care obligations. He cites one case in particular and highlights that there are sometimes
insurmountable obstacles for patients accessing charity care funds. Yes, it
looks pretty bad when a hospital sues a grieving widow for an enormous
amount of cash.

But Cohn’s account is more cynical than accurate. For every case like the
example he describes, there are thousands others that get done right. (Go
check out the IRS’s database of Form 990.) Non profit hospitals eat
millions and millions of dollars of medical bills every year. In combination
with shortfalls in reimbursements from medical assistance (Medicaid
programs), and astronomical liability insurance premiums, charity care costs
are often far more than the tax break non profits enjoy.

There is a distinction between indigent care- services provided to those who
don’t pay- and charity care- services provided to those who can’t pay.
Often the two groups are the same, but it takes some finesse in figuring out
who’s who at patient intake- a process riddled with problems indeed. Sick
patients or their families don’t want to fill out a stack of forms and
disclose they are broke because they fear they will be denied care. No fault
of their own, these folks often don’t realize providing accurate financial
information will make them eligible for charity care.

Really, the lesson here is our health system is broken. Providing medical
care for the uninsured or underinsured should not fall to nonprofits only.
A basic, universal and just health care system is the only way to fix this
mess. – Dominic Sisti

Labels: charity care, Dominic Sisti, fine distinctions, non-profit, universal health care, wearing your bias on your sleeve