I read a Wall Street Journal article yesterday (and my details may be fuzzy) about a woman with limited health insurance who had to pay $105,000 up front to get life-saving treatments for acute leukemia. The Texas medical center where her local hospital sent her (the local hospital didn't have the equipment to treat her safely) wouldn't serve her without getting the money immediately, on that same day (it did relent, apparently, on the last 30K of the $105,000, giving her and her husband a couple of days to find the cash.) She still owes the hospital $145,000. Some of the hospital's billing has been called into question, eg, $20 for a pair of latex gloves. She has also been charged at a higher rate for some procedures than insurance companies pay (the hospital explained that insurance companies get lower prices because they bring in "volume.")
The article pointed that the hospital has had a spike in non-payments by people without health insurance, so it has become more vigilant about collecting money, including sending billing department representatives to hospital rooms with doctors to demand payment before medical procedures begin. The hospital calls this a "team approach" to delivering health care. The article also noted that the hospital is a non-profit, meaning it pays no taxes, is very well-endowed, financially solvent and often the only place people in the area can go for complicated cancer treatments.
The woman, who left a job as a bus driver, could have purchased better insurance, though it's possible she couldn't have afforded that. However, I wonder what have happened to her if she hadn't been able to come up with the cash. She and her husband weren't indigent or poor, but they weren't rich either. She apparently had a stark choice: pay the hospital whatever it asked in cash or die.
What do you think of this story? Should the ethic of payment trump every other? Should our mental health (adding financial stress to emotional stress) be traded for our physical health? Are our priorities out of whack?
I think it is immoral for health care to be treated as a commodity, as we do in this country. For someone to die because they don't have money for treatment (or for basic health screening and prevention) is as outrageous as having to fork over one's credit card to a firefighter or a policeman before they'll act in an emergency.
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