Broken Health Care System --> Charity Care Mess

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