U.S. Government shuts down.

[kandrathe]

I just couldn't let something pass that was so very wrong.

c) a health care facility who had to write off the unpaid health care of the uninsured

This does not happen. I've had this very discussion (insured vs. uninsured) with facilities that have provided my care. Any care that is "written off" is actually rolled into the rates that everyone pays. Our health care costs are a huge game between providers and insurers and we are all under the thumbs of their bean counters. And, their beans are more magical than Jack's. They just keep growing and growing. Provider sets rates. Insurers contract what portion they pay. Provider decides they might lose money and adjust rates up. Insurers adjust contract.... Did you know that you will be billed at lower, somewhat more realistic, rate if you declare yourself uninsured before you ever receive care? Also, if they do bill you at insured rate, it is against the law to adjust down to the lower rate. The bean counters keep an eagle eye on it all. A simple check mark in a box or change in code and they can ruin you, but neither insurer or provider will ever lose! I've had to contest bills that should never have been my responsibility under my insurance plans. My parents are currently in a situation where they went from covered by insurance to paying hundreds of dollars a day because a bean counter moved a check mark from one box to another. They are trying to resolve the problem but being run in huge circles.

Bean counters, both provider and insurer, run our health care. They do not lose. Nothing is ever "written off"!

60 minutes says so. This was 2009, but I doubt it has changed significantly since then.

"Won't hospitals go broke if they give discounts to the uninsured?

That's highly unlikely, according to our research. The hospital industry made near-record $26.3 billion in profits in 2004 (the last year for which figures are available), according to the American Hospitals Association. As many as 25 percent of hospitals – particularly municipal hospitals which handle mostly the poor – lose money, the AHA claims. But other hospitals – both non-profit and for-profit hospitals – make handsome profits. According to the AHA, the average hospital's profit margin is 5.2 percent, the highest in six years. "

and...

The bottom 25% of hospitals reported spending 1.43% or less of expenses toward bad debt. The median hospital reported bad debt totaled 2.45% of expenses. And the top 25% of hospitals spent 3.89% or more of expenses on bad debt.

http://www.modernhealthcare.com/article/.../301069983


So... I think what happens is that "bad debt" is just a foil for justifying outrageous prices for those that will pay them, be they the uninsured, the government, or insurance companies. But, it takes the government to figure out how to spend $110 billion per year to resolve a $40 billion dollar per year problem.