[Winona Online Democracy]
To help me understand this--are you saying that the agreement is that uninsured persons will only be billed the "usual and customary" fee that the big guys like the "blues" pay in their contracts?
I understand that the reasoning for setting fees the way providers do is to make up for the folks who either don't or can't pay. Another reason is that if a provider accepts MA or medicare patients, those 3rd parties pay well below the "usual and customary".
I think the idea is that the folks who have coverage with a straight 80/20 will pay 20% of the fee that is higher than what the big insurance companies say is the "usual and customary".
You are correct that uninsured people end up having to pay a greater amount to the provider than comes out of the pocket of any insured person--at least what the insured person pays directly to the provider. If you allow for the huge amount in premiums and deductables that the insured person pays, are the fees really so unfair to the
uninsured patients? Possibly not.
Isn't part of the problem that the third parties who collect all those huge premiums and deductables also set the "usual and customary" fee? MA and Medicare also set their own payment schedules which are quite low compared to even the big blues' usual. To me this is not a "free market" system where the market sets the price. It is a system controlled by the big insurance companies who are making lots of money for their investors on our backs!! (Can you tell I feel strongly about this subject?)
Non-profit hospitals such as CMH are in such a financial bind and have been for some time now. We are fortunate in our community to have the generousity of citizens to contribute capital funds to support our local hospital and creative leadership to explore new and innovative ways to remain successful.
It bothers me that the focus of the efforts Paul describes is on the providers without addressing the other aspects of the system that is horribly unbalanced.
Kathy Seifert
----- Original Message ----- From: "Paul Double" <[EMAIL PROTECTED]>
To: "Online Democracy" <[email protected]>
Sent: Thursday, May 05, 2005 9:56 AM
Subject: [Winona] Healthcare - Fairness Prevails
[Winona Online Democracy]
In an article today in USA Today by Julie Appleby "four hospital systems - Allina, North Memorial, Park Nicollet and HealthEast Care -say they will offer discount so to uninsured patients with household incomes below $125,000. Such patients would pay an amount no greater than what is paid by large insurers."
"The agreement will remain in effect for two years. Minnesota hospitals ..have demonstrated bold leadership in tackling this problem," said Minnesota Hospital Association President Bruce Rueben."
The Minnesota settlement, negotiated by Attorney General Mike Hatch is the first state to broker such a deal to settle class-action cases in nine states.
"While good news for patients.... It's sad that it requires intervention of the attorney general to get this information out to the public and to stop the overbilling of uninsured patients." Mark Rukavina, Access Project.
Will the Mayo System, Franciscan Skemp Healthcare, Gundersen Lutheran and CMH-Winona Health follow this important fairness practice?
Paul Double
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