On November 1, 2002 it was reported that Colorado’s urban hospitals dramatically increased profit margins with HealthOne (an HCA company) reporting a 55 percent increase from 2000 to 2001. One wonders how much of this hospital system’s profit is at the expense of not providing free care for the uninsured. About 14% of Denver’s population has no insurance yet HCA/HealthOne provides a miniscule amount of charity care compared to other hospital systems. As a provider for the last 10 years in Denver I saw hospitals provide less and less charitable care for the uninsured. Several patients without insurance came to me for surgery last year. These patients were referred to Rose Medical Center (an HCA facility) to ask about free care and all were told that the care would not be free. They were told they had to pay full rates over 3 installments. One patient was asked to make a $20,000 deposit and pay the remaining balance of several thousand dollars over the next 2 months. I performed colonoscopy on my cousin who had no insurance for free but Rose Medical sent him to collections for over $2,500. Since hospitals are getting less from insurers and HMOs, the uninsured are being asked to pay full charges and often aggressive collection tactics are used. In June the House Committee on Energy and Commerce initiated preliminary investigation into this kind of hospital billing and debt-collection practice.
High hospital markups also contribute to hospital profits but this drives up health care costs. HCA/Rose Medical Center is among the 100 U.S. hospitals with the highest markups in their gross charges over costs. This list is published on www.calnurse.org. Rose is number 61 on the list with a markup of 583% over actual costs. For each $1,000 it costs to provide your care, Rose charges an extra $5,830. For-profit hospital systems such as Tenet and HCA dominate this list. Tenet is under investigation and HCA just settled the largest health care fraud case in U.S. history for $1.7 billion.
No wonder hospital profits are soaring. So are our health care costs. These kinds of hospital billing and pricing practices, especially by for-profit hospitals, call for greater public scrutiny and government oversight.
