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Bigger Hospital Bills for Those Without Insurance

September 11, 2004

Re "Hospitals Are Gouging the Uninsured," Commentary, Sept. 7: Ruth Rosen's article regarding hospital bills to the uninsured focused on one issue of our current healthcare crisis and ignored many more. Federal regulations govern what hospitals must charge those individuals who are not cared for under a contract with an insurance company. The administrators of the hospitals where I work tell me they are liable for prosecution or insurance fraud if they try to negotiate a price with an uninsured patient.

Rosen uses the example of single mothers who work at Wal-Mart but can't afford their "unaffordable" health premium. I agree this happens to some. But, in my experience, for most it is about financial responsibility and responsible decision-making.

Many lower-income employees can afford the premiums; it just means they may have to prioritize and possibly give up the cellphone, keep the used car another year or two or give up a $5 pack of cigarettes each day. Or, God forbid, develop healthful dietary and exercise routines.

Now the class-action trial lawyers are going after hospitals in a big way for the actions Rosen describes. I don't have any misconceptions that will do any more than line the pockets of the trial lawyers. Our healthcare system is falling apart. It needs comprehensive reform.

Gordon Tagge MD

Chelan, Wash.


Rosen is right to point out that the bloated bills hospitals send to their patients and the real amounts that hospitals accept from insurance companies, Medi-Cal and Medicare are outrageous. As a former "utilization review nurse" working with an insurance company, my task was to compare hospital bills with the written document of treatment given, the patient's chart. I know that hospitals charge for services not rendered and treatments not given, as do doctors billing insurance companies.

It is unfair that the man described by Rosen should have to pay the hospital $50 a month for 30 years when he could be paying the same amount for a little over four years if he were charged the same amount of money as the insurance company. But he does not have a contract with the hospital.

Will SB 379 create a contract between uninsured workers and hospitals similar to the state's Medi-Cal program, the federal Medicare program or the state workers' compensation program? Because each of those programs pays a different dollar amount for treatment, Rosen is an optimist to think that the California Hospital Assn. would agree to this arrangement.


von Brauchitsch



My eyes welled up with tears as I read Rosen's heartfelt and damning expose of how hospital billing practices are literally bankrupting the uninsured.

Recently, I went to the hospital because of a food poisoning incident. In sum, I spent six hours in the ER, most of it sleeping. The size of the bills I received in the mail shocked and outraged me. After being billed for everything from a $700 "consultation" to $3,000 for "emergency care," I am expected to pay $5,000 in total expenses. I am apparently one of millions of young people without health insurance, as Rosen describes, yet not poor enough to qualify for government programs. I am simply a struggling college graduate.

It is outrageous and immoral that "healthcare" providers are allowed to increase their already record-breaking profit margins on the backs of the poor.

Brian Randol

San Diego

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