Hospital must also aid underinsured patients

Yale is embroiled in yet another set of legal battles as lawsuits on behalf of poor patients at Yale-New Haven Hospital are pending in courts. The lawsuits, brought by state Attorney General Richard Blumenthal and a group of Yale Law School students, respectively, are meant to highlight the abusive debt collection process employed by Yale-New Haven Hospital, which includes liens on patients’ homes and garnishment of wages from patients’ salaries.

Blumenthal and the Yale students contend that many of the patients who are facing these debt-collection tactics were in fact eligible for the hospital’s free bed fund, a charitable fund that allows the hospital to write off a patient’s medical bill if his income is at or below 250 percent of the federal poverty line. In other words, the patients shouldn’t have had to pay a single red cent, let alone face aggressive debt-collection.

One main bone of contention between the state and the hospital is how to determine which patients qualify for these funds. Reacting to Connecticut state law SB 568 on hospital billing practices that went into effect Oct. 1, the hospital said that while it would continue to use its free bed funds, it would cease to use the funds for patients who have any insurance. The hospital contends that it made this adjustment to take the new law into account, but both Blumenthal and the law’s author, State Senator Martin Looney of New Haven, argue that the hospital is misinterpreting the law to hurt its poorer patients.

At first, the hospital’s stance seems completely logical. Free care funds should be given to those who need them most — those who have no health care insurance. Nationally, this number has risen to over 43 million, or over 15 percent of the population. Surely, it would seem, these are the people for whom the funds were created.

Yet as the health care crisis explodes on the national level and the number of uninsured increases, the number of underinsured is rising as well. As health costs increase, more and more people are finding that the health insurance they relied upon was not adequate, for example, because of oppressively large co-pays and deductibles or because not all health plans cover all medical procedures.

While researchers have found ways to measure the growing number of uninsured in this country, it has become increasingly difficult statistically to count the number of underinsured. Nevertheless, both politicians and patients can be sure that the number is rising, effectively creating an even larger population of uninsured in this country.

The hospital should be commended for recently reforming its debt collection process, most significantly seen in its dropping of all but 125 liens out of 125,000 and adding procedural obstacles to filing a new lien placement or wage garnishment. Both sides can agree that these changes brought long-needed relief to many in the greater New Haven area.

Yale-New Haven brags about the progress in its reforms, but then defends the debt collection it still practices. In defending the limitation of its free bed funds, hospital spokeswoman Katie Krauss said in a press release, “there is a systematic challenge facing all hospitals and health care providers in the United States.” In other words, until the national health care problem is solved, Yale-New Haven claims it cannot be expected to present a perfect health care program to all of the uninsured and underinsured who use the hospital.

The health insurance problem must be solved on a national level, but the federal government is no closer to solving it than it was in the days after the collapse of the Clinton efforts at health care reform in the early 1990s. In fact, with the recent “prescription drug” bill passed by Congress that looks more like a handout to the nation’s insurance companies than to the nation’s retirees, we are closer to dismantling the public health care system we have than to creating a better one to care for the millions of uninsured Americans.

Until there is a new administration and a new congress, local hospitals, employers, and states must work within the system to close the growing health care gap. The state of Connecticut took a small yet important step in passing SB 568. Yale-New Haven Hospital must now do its part.



Alissa Stollwerk is a sophomore in Saybrook College.

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