Three reports in this week’s New York Times document the magnitude of harm produced by America’s profit-driven, healthcare system affecting–not only the uninsured poor–but affecting all but today’s Robber Barons, the .001% of Americans–who are being mistreated and pick-pocketed.

The commercialization of American Medicine has obliterated medicine’s humanitarian mission, adopting a rapacious business model. Medical institutions are now being run as disreputable for-profit businesses.
Patients entering a hospital emergency room in need of medical care are being abused, detained and grilled, as if they were criminal suspects.

Healthcare providers and insurers, in the pursuit of increased profits, have resorted to ruthless tactics befitting Mafia enforcers or loan sharks, when interfacing with patients. 

Insurance carriers are denying insured "middle class" taxpayers their paid-for entitlements by changing the reimbursement rates. 
Hospitals, in turn, are demanding pre-payment from patients at the  point of admission–the Emergency Room.
 
And, hospitals are hiring mercenary collection agencies–such as Accretive–whose agents run amok on hospital floors indistinguishable from hospital staff, terrorizing patients with demands for payment.

The Times reports, "Collection activities extended from obstetrics to the emergency room.  In July 2010, an Accretive manager told staff members at Fairview Hospital that they should “get cracking on labor and delivery,” since there is a “good chunk to be collected there,” according to company e-mails."

Insurance companies and collection agencies are making a killing in profits and hospitals are part of the pivotal leg in that Troika.

The Times reports that:  Accretive is one of the few companies specializing in hospital debt collection that is publicly traded. Last year, it reported $29.2 million in profit, up 130 percent from a year earlier.

Vera Sharav

~~~~~~~~~~~

THE NEW YORK TIMES

1. Insurers Alter Cost Formula; Patients Pay,  April 24, 2012. 

The article describes how health insurers have pulled the rug from under insured Americans.
The insurance industry has shifted its reimbursement formula for hospital services. Insurance companies had paid 70%  of "usual and customary cost" for hospital services.  Now those insurers are shifting the major cost of hospital services to patients by adopting  Medicare rates of reimbursement.

For example, Appendix  removal: Amount billed: $7,704—-under "usual & customary cost" Insurance paid $5,393, and patients paid $2,311.
By shifting the reimbursement rate to Medicare standards (depending on whether the hospital is within the insurance company network):
Insurance company pays only $653 to  $1,166, and patient is charged $6,538 to $7, 051.
No, this is not a typo! 

2.  Debt Collectors Pursue Patients Inside Hospitals, April 25, 2012.

"Hospital patients waiting in an emergency room or convalescing after surgery are being confronted by an unexpected visitor: a debt collector at bedside. 
This and other aggressive tactics by one of the nation’s largest collectors of medical debts, Accretive Health, were revealed on Tuesday by the Minnesota attorney general, raising concerns that such practices have become common at hospitals across the country. The tactics, like embedding debt collectors as employees in emergency rooms and demanding that patients pay before receiving treatment, were outlined in hundreds of company documents released by the attorney general."

"And they cast a spotlight on the increasingly desperate strategies among hospitals to recoup payments as their unpaid debts mount. To patients, the debt collectors may look indistinguishable from hospital employees, may demand they pay outstanding bills and may discourage them from seeking emergency care at all, even using scripts like those in collection boiler rooms, according to the documents and employees interviewed by The New York Times."

3. Confusion On Pricing At Hospitals Adds to Pain , April 24, 2012.

"When Augie Hong awoke with severe abdominal pain nearly two years ago, he went to the hospital emergency room closest to his home in San Francisco. The diagnosis was acute appendicitis, and doctors removed his inflamed appendix.

Mr. Hong had health insurance, so he wasn’t too worried about paying. Then the bills started to arrive. “That’s when I got nervous,” said Mr. Hong, 36, who has insurance through his job at an investment firm.  In all, Mr. Hong was charged $59,283, including $5,264 for the doctors.

"Hospital charges are all over the map: according to a report published Monday in the Archives of Internal Medicine, fees for a routine appendectomy in California can range from $1,500 to — in one extreme case — $182,955. Researchers found wide variations in charges even among appendectomy patients treated at the same hospital."