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Our Purpose
The purpose of the Hospital Victims project is to help the uninsured, encourage transparency in hospital prices, bring an end to the disparity between the uninsured and the insured, and to help victims overcome financially impossible hospital charges.
What you need to know
Hospital Bill. The real problem people face with medical bills is the hospital bill. Often times hospital boards and administration put profit margin over the plight of the patient. This is evidenced by patients being stuck with “financially impossible” bills. Too many times patients are forced into high interest rate loans as revealed in Business Week’s article, titled, “Fresh Pain For The Uninsured”, bankruptcy, or a poor credit rating. The disparity and the suffering continues.
Evidence indicates that hospitals are charging much higher prices to the uninsured than they charge to the big insurance plans, and Medicare. Because it is so important for the individual to have a favorable credit rating, the hospital's collection firm poses the threat of causing you to be labeled a bad credit risk. Hospitals have created relationships with major credit companies to take over patients bills and impose high interest rates! There is a strong belief that profits are made on the back of the uninsured. Data suggests that this is indeed true!
Your credit rating is valuable and needs to be protected from hospital charges. We can help you avoid these charges to be used against you. What you must do is challenge the reasonableness of the bill under the federal Fair Debt Collection Practices Act. We provide information and a proposed letter to be sent by the patient to the hospital and to the firm that is doing collections for the hospital (usually a law firm that specializes in collection).
What you need to know. If you wish to dispute to the hospital the amount the hospital has charged you, it is important for you to know (a) what the hospital's cost are in relation to what the hospital normally charges; and (b) what Medicare would pay. By law, Medicare is required to pay hospitals an amount that is a little more than the cost of an efficient hospital. Hospitals will consistently complain that the Medicare payment isn't reasonable. The Medicare payment rate is a good beginning point for arguing with the hospital about their bill to you. The nation's preeminent authority on reasonable price is Dr. Gerard Anderson out of Johns Hopkins Hospital School of Medicine in Baltimore, Maryland. We can provide you a copy of his testimony before Congress in which he said that 25% more than Medicare is a reasonable price for an uninsured individual to pay.
UB-92, or UB-04. After first disputing the charges using the federal Fair Debt Collection Practices Act, you next need to demand from the hospital a UB-92 or UB-04 covering the charges for the patient's time in the hospital. The letter we provide for you to use in challenging the bill to protect you credit rating also contains a statement demanding the UB-92 or UB-04. At this point it is likely that the hospital will want to talk with you or be willing to talk with you about the bill. The hospital will likely assert, "This is our standard price. This is what we charge everyone." On this website you can find the discount the hospital normally gives to insurance off of their list prices. It is a starting point for you to argue that you should get the same discount. Then you can argue that the nation's preeminent expert, Dr. Gerard Anderson, in his testimony before Congress asserted that Medicare plus 25% is the reasonable price for the uninsured person to pay.
At this point, collecting from you is no longer a simple collection case for now the hospital has to prove the reasonableness of their charges. The collection firm may want to give this case back to the hospital, to turn over to the hospital's corporate lawyer. That means your bill is now trouble for the hospital and be much more willing to settle for a reduced amount.
The hospital may have a discount program for people below 400% of poverty. On this website, you can find out the income level that represents 100%, 200%, and 400% of poverty.
Important Precedent. The Daughters of Charity Catholic Hospital chain in California has adopted a policy giving discounts to all uninsured who have income at or below 400% of poverty. The uninsured with income above 400% of poverty are given a price equal to what Managed care would pay. We have on this website a copy of the Daughters of Charity policy.
Non-Profit Hospitals. The hospital may assert to you that, after all, they are a non-profit hospital. The evidence is that non-profit hospitals go for the money. There is generally no difference in the prices charged by for-profit and non-profit hospitals. Following is a quote from New York Times: November 23, 2005
New York Times reports "Hearings have terrified nonprofit leaders.." In an article in the New York Times reporter Stephanie Strom wrote "Nonprofit hospitals provide no more charity care than taxpaying counterparts do."
She went on to write "So what is charity today if it is not aimed primarily at the have-nots? Has its definition been stretched so broadly that it no longer has meaning? If so are tax breaks that propel our philanthropy justified? Representative Bill Thomas, Republican of California, the chairman of the powerful House Ways and Means Committee, has raised those questions in a series of hearings examining whether tax exemption is justified for certain types of nonprofits."
Later in the story she writes "The hearings have received little public notice but have terrified nonprofit leaders . . . "
Senator Grassley (R-Iowa) has said "When nonprofit hospitals sit on big cash reserves, I wonder how much public service they're offering."
Catholic Hospitals and the excessive profits of not-for-profit hospital organizations:
The Profits of 5 Not-For-Profit Catholic Healthcare Systems
| System Name |
Year End 06/30/05 |
Year End 06/30/06 |
One Year Net Increase |
| Catholic Health Initiatives |
$498,374,000 |
$693,701,000 |
$195,327,000 |
| Catholic Healthcare West |
$348,156,000 |
$437,917,000 |
$89,761,000 |
| Ascension Health |
$627,220,000 |
$802,965,000 |
$175,745,000 |
| Trinity Health |
$329,462,000 |
$601,816,000 |
$272,354,000 |
| Providence Health* |
$360,944,000* |
$457,143,000* |
$96,199,000 |
| Total 5 Systems |
$2,164,156,000 |
$2,993,542,000 |
$829,386,000 |
* Results for Providence Health year ends are 12/31/05 and 12/31/06 respectively. |
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