Thursday, December 4, 2008

Illinois passes law that requires hospitals to adjust bills of uninsured patients

This is awesome. As many of you probably don't know, most hospitals have Byzantine payment systems. For example, Mary, who is uninsured, goes to have her cholesterol levels checked at the local hospital. She is charged $250. Lucy, who is insured, also has her cholesterol levels checked at the same local hospital. She is billed $250. But then her insurance company tells the hospital "No you can't charge Lucy that much. That's above the 'allowed amount'. Instead, the hospital only asks Lucy to pay $100. So, the uninsured woman pays $250 out-of-pocket, the insured woman pays $100 out-of-pocket, the insurance company pays nothing, and the hospital profits greatly off of the uninsured woman.

In most industries this would be called price discrimination and would be considered illegal, but not in the health care industry. So, the uninsured, often the least able to pay, have to pay more out-of-pocket as individuals.

Well, at least in Illinois there is some relief. According to the Wall Street Journal Hospitals can now only charge the uninsured cost plus 35%. Not exactly a great deal, but it is something. Usually hospitals charge patients cost plus 150% and they accept as payment cost plus 2% from Medicare and cost plus 10%-15% from insurance companies and their policy holders.

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