logo

Thursday, January 8, 2009

Wallet Biopsy

Have you ever had a wallet biopsy?

Probably not, but according to Business Week this is a practice that can be eye opening.

Hospitals are forbidden from refusing service, regardless of ability to pay, when you have a life threatening emergency. They are required to treat you, at least up until the point your condition is stabilized.

But after that, they can withhold services if you lack the ability to pay.

Debbie Maupin, 41, already has felt the procedure's sting. The Dallas resident fractured her skull, neck, and back in a car crash in April 2005. Parkland Health & Hospital System gave her free care worth more than $100,000 because her job as a mortgage adviser offered no health insurance. When she returned in June 2006 for a scheduled CAT scan, however, Parkland told her she no longer qualified as a charity case "because my credit score was too high," she says.

Granted, a high credit score means you have demonstrated an ability to manage your money . . . it does not mean you have money in the bank.

Still, I have a problem with someone who does not have health insurance and uses the excuse that they do not have insurance because their job doesn't offer it. We know nothing about her health before the accident, or her income, but apparently it was too high to qualify for Medicaid. It is possible she could have purchased health insurance, but simply chose not to.

So why didn't she purchase health insurance on her own?

Parkland analyzes credit scores when deciding who can afford to pay for care.


They also look at credit card balances, 401(k) balances and estimates of income. What's wrong with that?

"We are very generous in our charity care, giving over $100 million in free care last year,"

Hospitals give away millions each year in uncompensated care. One of our favorite topics here is Grady hospital, the local taxpayer funded, charity hospital. We recently pointed out that Grady is auditing those who receive free care and letting them know the party is over.

Evelyn Leonard earns $18,000 per year. According to Halifax Medical Center in Daytona Beach, she meets their standard for charity care. When she wanted a procedure for a non-emergency treatment they offered a 50% discount.

She indicated she could not pay, so they asked about her 401(k) funds. She has opted not to tap those funds to pay for care.

Halifax's vice-president for patient business and financial services, won't comment on Leonard's case, citing patient confidentiality. "Part of our mission is to provide care to people who fall through the cracks, but we cannot incur a cost that taxpayers and the community cannot bear,"

Halifax is a taxpayer funded facility that gave away $41 million in uncompensated care last year.

I have no problem with my taxes going to pay for care for those who do not have the ability to pay, but I do take issue with those who fail to accept personal responsibility and purchase insurance or pay their debts.

All of us need to eat to sustain life. If someone walked into a grocery store, or restaurant, and helped themselves to food then walked out without paying, no one would think there was anything wrong with the grocer or restaurant owner pursuing payment.

But for some reason when someone has the ability to pay for health care, but refuses to do so, then there is a public outcry.

Something is terribly wrong with this picture.

MVNHS© on a Roll

But not necessarily a good one:
That last bit is especially frightening: if it's "officially" as bad as 60%, and the "actual" number could be much higher, what does this say about socialized medicine, and the efforts of our own political class to implement a similar scheme here? We're constantly subjected to the (oft-debunked) canard that our health care system is "failing," and "too expensive for the benefits received," ad nauseum.
But here's a real life example of a system which apparently takes killing its "patients" a little too casually (as we've seen before). It's reminiscent of the silly "infant mortality" myth, because we count every live birth, regardless of potential problems, whereas most other countries (and hence health care systems) only count those that survive a specific number of days.
So how many folks has the MVNHS© killed today?

Split Personality

I have a confession to make.

I have a split personality.

No, not the psychological disorder, but let's just say I am multi-faceted. In addition to my indentured servitude here on InsureBlog, I really do have another life.

I am a full time health insurance broker in Atlanta (technically, Sandy Springs) specializing in health insurance for individuals and small businesses.

In addition to InsureBlog, I post on my own site at Health Insurance 411. If you check the stats, H I 411 has about 100 posts while InsureBlog over 10,000 (or something like that).

InsureBlog focuses mostly on health insurance, particularly as it relates in a "big picture" kind of way.

H I 411 is/will be focused more on issues as it relates to individuals and small businesses located in Georgia.

I will continue to be the insurance curmudgeon on InsureBlog that many have come to know and despise, but will also be reviving my interest in H I 411 by addressing local issues, particularly as they relate to my client base in Georgia.

Hank has garnered thousands of regular readers from around the world through his quality work here at InsureBlog but I am putting him on notice. I fully expect to draw untold numbers of regular readers to H I 411 over the next few months.

As my wife said not to long ago, "Does anyone other than you & Hank actually read that stuff?".

Well my dear, we will see. And, thanks for the vote of confidence.

Enjoy!

Tuesday, January 6, 2009

Fitness Mandate

Want to lose weight and get in shape for the New Year?

Move to Maryland.

Seriously.

A local (LaVale, Maryland) gym owner wants the Maryland General Assembly to support the Personal Health Investment Today Act which allows residents to use flex and health savings accounts "purchase fitness club memberships and equipment".

Yup.

Sounds great, right?

While such a move is noble, how do you rectify the use of qualified funds in a federally tax favored account to pay for these things when the U.S. Treasury does not allow such a use?

Using your HSA to fund expenses that are not allowed means you must pay a tax and penalty.

I don't suppose anyone thought this through.

Things Your Provider May Not Be Telling You

Does your doc tell you about health insurance? Does he or she inform you of different plans available to you?

If not, things may be changing soon.

If legislators in New Jersey get their way, you may not be able to leave your providers office without getting a pitch for health insurance.

Assembly Bill 3488 would require all licensed kennels, pet shops, shelters, pounds and anyone in the business of selling pets to provide written notice to customers regarding the availability of pet health insurance offered in New Jersey.

OK. I took some liberties in introducing this story, so get over it.

For certain, pet care can be expensive. Even beyond the routine immunizations, check ups, shampoo and nail trimming you can also get into canine dental work.

A "routine" cleaning can run $400 or so.

Who knew?

If this passes, when you purchase a pet you might hear "would you like health insurance with your dog?".

Another bill introduced in the state would increase fines to pet stores that violated certain laws and regulations, such as licensing requirement. Current penalties range from $5 to $50; the proposed penalties would range from $100 to $1,000.

According to the bill, the purpose of the measure is to “enhance the power of the state and its municipalities to enforce certain laws regulating the treatment of animals.”


Are we legislating stiffer requirements for pets than humans?

Sounds that way.

Apparently the N.J. legislators have a lot of time on their hands. Why don't they do something really important like finding Jimmy Hoffa.

Grand Rounds: First 2009 Edition

Edwin Leap hosts this week's collection of great medblog posts. There are a lot of good items here, and he obviously read them all: each one has a helpful summary.
I must say, though, that I was a bit put off by the rather lengthy intro Edwin wrote; it's his take on the theme ("profit in health care"), which is fine, but it's also nine paragraphs long. I think that's a bit much.

Share

Twitter Delicious Facebook Digg Stumbleupon Favorites More