Non-profit hospitals shy away from those who can't pay

It seems that everyone is pessimistic about healthcare. Doctors don't care enough about their patients, hospitals are cold, faceless entities, and you can't even talk about health insurance these days. In a time when the Obama administration is calling for a reevaluation of the U.S. healthcare system, it is clear that the public wants change. It's true that changing healthcare in the U.S. to resemble other (better) foreign plans might work in the longrun. There is a lot to discuss on this front, and big industry forces will inevitably have a say. However, healthcare, to me, is much more important as it pertains the little guy - yes, I'm talking about Palin's infamous Joe the Plumber.

Yesterday, The Chicago Tribune revealed a trend in patients who have been turned away from non-profit hospitals due to their inability to pay for care. While the number of hospitals in the U.S. is currently decreasing, those that operate under not-for-profit status are the major type in the U.S. These hospitals receive tax cuts due to their charitable mission. They are intrinsically community-oriented, yet the information in the Tribune points to a messy situation. Non-profit hospitals are sending patients to large, public hospitals for care - basically passing the buck along. One healthcare expert referred to this as "patient dumping." This makes for long waits at the public hospitals and poor quality of care. Meanwhile, aren't these non-profits supposed to be catering to the community? It turns out, "non-profit hospitals in Cook County dedicated just 2 percent of their total revenue to charity care in 2007—1 percentage point more than for-profit hospitals that don't receive tax breaks, according to an analysis of the most recent state hospital revenue data."

The big question is how should hospitals evaluate quality of care? When it comes to non-profits, I am in favor of more stringent regulations to ensure that they are serving their target population. Otherwise, there is no reason that they should reap the benefit of a tax cut. While the Tribune article focuses on one Illinois county, this problem is certainly not unique. In Baltimore, for example, health disparities are great, incomprehensible, and just plain ridiculous. In that city, dominated by Johns Hopkins Hospital and several other reputed healthcare centers, the reason that Medicaid users and others do not receive care is still heavily debated. The potential factors are related to convenience, trust, cost, and, in some ways, access. Nevertheless, it is not hard to imagine that Baltimore residents are facing the same red tape as those in Cook County - if they make it to the hospital at all.

Non-profits: you can do better.