OK, I’m going to drop the professional veil here — or breach the fourth wall, if you prefer a theatrical metaphor — and share the tale of how my mom got stuck with a $25K hospital bill. Then I’ll tell you why you should care.
First, feel free to assume that my mom, while rich in spirit, isn’t much of a financial high-roller. Like most Americans, she knows little about how health plans or hospitals operate, despite being a very intelligent lady. And while she’s hell on wheels when it comes to advocating for my special-needs brother, I’m sure she finds it harder to fight tooth and nail for herself, especially given that she has very little idea of how to start.
Now comes the part that makes me want to rip my flesh with my bare hands.
My mom recently got vital medical treatments at a hospital in the Boston metro (ahem, Mass General — did I say that?), which were going to be paid for by her health plan.
Since then, however, she has been told by the hospital’s so-called “financial counselor” that a) Allstate wouldn’t pay for the treatments (unknown to her, because no one from the hospital’s staff warned her!) and b) despite having a miniscule income, she didn’t qualify for some assistance program the state offers, which meant that Allstate’s gain was her loss.
OK, let me get this straight. The hospital’s staff fails to verify her coverage for a very expensive treatment (something that may not be a legal obligation, but certainly seems like common sense and ethically appropriate for both parties). They fail to tell her that the coverage fell through and give her at least a choice about proceeding or not. They proceed to bill a low-income grandmother $25K for the procedure — and never ONCE suggest to her that as a non-profit, they have, let us say, a few obligations in the “helping patients” department.
Why should you care about my family’s travails? Well, for one thing, it points up a sad reality — that despite high-profile lawsuits spanking hospitals for behaving this way, and a growing flood of state laws demanding sliding scales for uninsured patients, that top-ranked hospitals still pull this crap whenever a regulator’s back is turned. It’s more than cruel; it’s foolish in the extreme.
With our good friend Chuck Grassley still campaining for minimum charity spending by hospitals (last quote I heard was that he’d like to see 5% of gross revenues dedicated to charity care), it doesn’t make a whole lot of freaking sense to put a target on your facility’s front door. Expect Congressional and state paintballs to smack the heck out of that target, and soon.
Oh, and there’s the small matter of what could be construed as, oh, fakery in the first degree. Mass General bills my mom for a service she could never, ever afford in the first place, then almost certainly writes it off as charity expense — while continuing to press my mom for blood from a stone. See, we’re so charitable, IRS, aren’t we? Yes, I know that this tactic has been decried for decades, but I’d argue the time has come to call a halt on it for good. Hey, the health plans’ shenanigans are in the news today, but you could be next.
The bottom line, honestly, is I’m just plain pissed – not just for my mom, but struggling people everywhere in the U.S.. Dammit, this just shouldn’t happen! But at the same time, I’m professionally offended by this kind of behavior. Shame on you, Mass General. I hope somebody there makes this right — and makes plans to clean up their act – or I’m going to be all over them like a bad haircut. Just see if I don’t.