published Sunday, April 29th, 2012

Erlanger's 'free' health care

First, the good news: Erlanger Health System has adequate reserves on hand to pay its debts, and there is no reason to think it will stop providing the sound care for which it is known throughout our region.

Now, the bad news: Erlanger has had more than $17 million in losses in just the first nine months of the current fiscal year -- including a dramatic $4.1 million loss in March alone.

Why?

Count the reasons:

• Doctors have moved revenue-generating surgeries to different hospitals.

• Layoffs that will improve Erlanger's finances to the tune of millions of dollars nonetheless came with a $900,000 bill for one-time severance pay.

• Admissions were down in March.

• And Erlanger has seen a sharp increase in uncompensated care. That care amounted to a hefty $83 million in the previous fiscal year, but it is expected to surpass the $91 million mark this fiscal year.

Not surprisingly, these alarming numbers and circumstances have Erlanger earnestly seeking ways to stem its losses. We hope those efforts succeed, and soon.

But the rise in uncompensated care is perhaps the most telling of all the things that are causing financial troubles for the hospital. It is, in fact, a symbol of what ails medical care in the United States as a whole.

We do not suggest that hospitals should turn away patients in dire medical need on account of their inability to pay.

But the compassionate instinct to care for the ill or injured, no matter their economic circumstances, does not erase one key fact: Medical care costs money, and there is no wishing those costs away.

Uninsured patients of limited means who seek care at a hospital emergency room may think they are getting "free" care.

But doctors, nurses, medicines, high-tech facilities and the myriad other things that go into providing patient care are anything but free. Somebody has to pay the tab, sooner or later, or else the care won't be available.

That's scarcely different, of course, from what plagues medical care across our nation. Everybody wants whatever care he desires, at the time he desires it, and without regard to the cost of research and development of drugs and medical devices or the cost of the extensive education required of medical professionals.

That unsustainable notion is embodied in ObamaCare -- which the U.S. Supreme Court should promptly strike down as unconstitutional. ObamaCare seeks to bring tens of millions of Americans onto government-run medical care, while promising that somehow this mammoth expansion of government actually will reduce health care costs.

In short, it purports to offer something for little or nothing -- which falls under the category of "If it sounds too good to be true, it is."

But as Erlanger's painful example shows, making medical care "free" to one group of people simply places those costs on another group.

Again, that is not to suggest that seriously ill people who cannot afford medical care should be left to suffer. But at least Erlanger -- unlike the Democrats who passed ObamaCare -- is honestly confronting the reality that benefits have costs.

Similar candor about ObamaCare likely would have prevented it from passing in the first place.

But a clear-eyed accounting of its costs and rigorous consideration of its potential unintended consequences were the last things on the minds of those who promoted that federal power grab.

Barring the overturning of the law by the Supreme Court, our nation probably is going to be living with those consequences for a long time.

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hotdiggity said...

Right On!! How silly for the greatest country in the world to consider providing adequate health care to its citizens. I mean, heck, what other of the major industrialized countries in the world offers better health care coverage than America? Oh, that's right, all of them. My bad.

April 29, 2012 at 12:42 a.m.
EaTn said...

Unwittingly, this right side article points out our broken health care system which will continue until the right-wingers face the facts that universal health care is the only solution, which Obamacare would have been had Obama not been derailed by politics and the greedy.

April 29, 2012 at 6:25 a.m.
hambone said...

If only everyone had insurance!

April 29, 2012 at 7:23 a.m.
LibDem said...

Why can't we have a panel that decides which "...tens of millions of Americans..." aren't worth saving?

April 29, 2012 at 8:31 a.m.
Welcome_2 said...

Several years ago when I lost my job and became unemployed I also eventually lost my healthcare insurance. COBRA was far too expensive to maintain the monthly preimums for the insurance my employer once partially paid. After becoming unemployed, I'd put aside a few hundred dollars to pay my primary care doctor I'd been going to while still working and I was insured just in case I needed to go the doctor until I could find employment. This was the year of a severe deadly flu epidemics hitting most all across the nation.

Now to make a long story short. When I was insured with good medical insurance, my doctors' office sometimes called me. At times wanting to see me once, even twice a week. Then I became unemployed. Lost my healthcare coverage. I was one of those individuals hit horribly by the flu epidemic that year. I called my regular physician whom I'd been going to for years while employed. I explained to them I was no longer employed, no longer insured, but I would be paying in cash. The receptionist said sure, and set up an appointment for me to come right in. However, when I got there and signed my name and wrote (none) where I'd normally name my insurance carrier, the office manager refused my appointment, and I was turned away. I had about 400 bucks on me, prepared to pay whatever, ANYTHING if they'd just see me. I was sick and weak I could barely walk. I left there and made it to the emergency room, where I was seen. I wasn't placed in the hospital, but I was immediately given medication on the spot, a breathing treatment (I'm also asthmatic) and some prescriptions. I did get better and didn't end up in ICU, thank GOD. While I was unemployed and had run completely out of money except for an unemployment check, I began to go to one of the clinics operated by Erlanger. I couldn't have asked for a more nicer, professional and caring staff of people. I only had to pay 20.00 for each time I visited the clinic. And if I didn't have the 20.00 they would see me anyway. Being uninsured, medical tests were limited. As they explained without insurance there's is only so much they're allowed to do. However, being uninsured, I was grateful for the care I did receive until I could get back on my feet. Especially being asthmatic and sometimes requiring breathing treatments. If you've ever been in a situation where you can't breathe and it feels as if you're lungs are about to explode, then you know where I'm coming from.

April 29, 2012 at 9:07 a.m.
nucanuck said...

Prohibit employers from providing health care and put everyone in the position of seeking out individual health care coverage. The insurance companies would howl and the whole system would collapse.

Those who have automatic coverage through their job simply can't understand the pitfalls confronting any individual trying to maintain health care coverage. Our current system is structurally flawed and so far, no one has come up with a better, more cost effective alternative system than single payer.

We should consider seperating employment from health care and creating a system that puts all Americans on equal footing.

April 29, 2012 at 10:16 a.m.
Rickaroo said...

Consider the 4000+ hospitals throughout the country that have their own costs for uncompensated care each year. The overall cost easily reaches the multi-billions. Those increases in premiums you see every year from your inusurance companies are due in large part to that cost. You people who complain about how it's not fair for you to have to pay taxes for the health care of others...well, you're already paying it! And paying it in the least cost effective way possible. Forget about the notions of fairness and social justice, which all conservatives hate so much (socialistic and all that); it would only make sense to have a system in place that would cover everyone on the front end (preventative care and early diagnosis), not the back end (the emergency room), and the most sensible way to do that would be to raise taxes (another word conservatives detest) a little on everyone and provide single payer coverage. It would not only be fair; it would also be the most practical and cost effective.

April 29, 2012 at 1:36 p.m.
Rickaroo said...

JonRoss, I used to sell individual health insurance policies. They suck. I got out of the business when I saw what a racket it was. It is far easier for insurance companies to deny a procedure to an individual or a family than it is to a large group and they do it all time. What's more, the vast majority of individual policy holders are forced to take a very high deductible to keep their policies affordable. In that case, you still have to pay an exorbitant amount of money out of pocket every time you go to the doctor. If you think that insurance companies would lower their premiums simply because more people with vouchers or whatever would be purchasing their policies, then you are delusional. They might lower them fractionally but not nearly enough to make them truly affordable to the average working class person or family. And you free market idolaters wouldn't even allow any regulations to keep the insurance companies from screwing us over, like they do all the time.

Your reactionary argument that if we make health insurance single-provider, then what's to stop the government from making everything else single-provider has no merit other than to play on the emotions of the already paranoid. Health insurance is uniquely different and should not be treated as a commodity. The health of a nation is vitally important to its strength and well-being. It serves the best interests of everyone to have a healthy populace. We have become so accustomed to thinking of health coverage as something that is bought and sold on the free market that it's difficult for you to see it differently. You don't give a second thought to calling the cops when you're in an accident or you have been mugged or beaten. Nobody stops to ask you whether or not you have police insurance. Well, why should we think that a citizen, especially one who works and pays taxes, should have to purchase heath insurance before they can be treated whenever their health is in jeopardy? I don't want matters of my health to be in the hands of some company whose bottom line is to make a profit at all costs. Profits are great...for certain things. But not in the matter of health care.

Your comment about Europeans and bad teeth: pathetic. I have known many Europeans throughout my life and not one of them has bad teeth, or at least no worse than the average American. You are truly grasping at straws, dude.

April 29, 2012 at 2:43 p.m.
EaTn said...

JonRoss...I can only assume you have either employer or govt subsidized insurance, or are wealthy enough to afford the unaffordable private insurance premiums.

April 29, 2012 at 2:58 p.m.
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