Good read: “No Cash for medical bills? Bartering pays”
On my days at the clinic it’s no surprise to see a long line of people awaiting a “meeting” with the billing department. Getting sick is expensive and not everybody has great heath insurance, let alone health insurance at all. There are a lot of different groups who have a interest in seeing that those bills get paid: the patient—unpaid bills equals added stress; the hospital or doctor—they need to receive payment for the care they give or care is going to suffer long term; the rest of us—unpaid bills are paid for by someone, most of the time it’s the average working joe,’ whether it be through more expensive insurance policies or reduced coverage through employers.
A friend forwarded me this article, which appeared on MSNBC’s website earlier this week. This is a great example of taking a system wide problem and finding a solution. If someone receives a treatment they cannot pay for let them them pay for it with manpower. For most, day-t0-day doctor and emergency room visits could be paid off with a half-way-decent “bartering system.” According to the U.S. Dept. of Health and Human Services the average cost of a primary physician consultation is $100, while the mean cost of an ER visit is about $560.
Patients could file charts a couple nights a week over the course of a month, pick up phones, collect garbage or vacuum the doctor’s office. This is only covers non-skilled labor, as the article mentions there are plenty of people with a trained skill that could pay their debt in a variety of ways. Another story on MSNBC ran awhile back featured an artist who paid for her checkups by painting with children in the pediatrics ward of a local hospital.
Naysayers may say this won’t work, not everyone will show up and help, or some people will do more harm then good. And they are partially right, no solution is absolute. But if this works just 10% of the time, it’s 10% more than it’s working presently.
Say the patient’s care is extensive and expensive, and worse case scenario they don’t have insurance. Say, their care costs $500,000, or even a $1,000,000. The hospital sets up a labor account, and the patient works as their treatment allows. Maybe it’s every other weekend at first, or a few hours two evenings a week. They can do non-strenuous activities like stuffing envelopes, or remedial data entry.
Even better, instead of sitting in the waiting room for hours at a time, let a patient work off the bills they can’t pay by doing something like preparing sandwiches while their doctor sees other patients.
And their friends should be able to help too. When your sick people always say “what can I do to help?”
Now sick people have a good answer. “Well, you can go down to the hospital four times this month and work for a few hours in my name.”
The work his or her friend does will then be credited to that patient’s account. Over time that bill is going to be trimmed, maybe it takes five years, maybe it takes ten. Maybe the bill is never paid in full, but it’s better than the other option— nothing at all.
August 21st, 2009 at 10:10 am
First, let me tell you how grateful I am to you for documenting your experience. My mother was hospitalized a week ago in NY state and her second diagnosis earlier this week was aplastic anemia. However, the jury is still out since the hemotologist and pathologist seem to have a difference of opinion. It has been suggested that she may have hairy cell leukemia. We are seeking a second opinion.
On Wednesday, the hospital attempted to discharge her. They indicated that she could receive the treatment for aplastic anemia on an outpatient basis. My sister (thank God for her Army medic training and clinical research experience) challenged that as being unacceptable based on the standards of care associated with the treatment (i.e., patient on these medications needs to be monitored). Evidently, there was some concern on the part of the hospital CFO and others that they would not be reimbursed sufficiently by Medicare. When they got wind of the fact the we were seeking to have her transferred to a different hospital, she was taken back to her room. Perhaps the concern with being left “holding the bag” on all the medication outweighed the concern of something less than full reimbursement?
I will be travelling to NY tonight and seeing my mother tomorrow. I will share your experience with her and check back on your updates.
Thank you and Godspeed.
August 21st, 2009 at 1:40 pm
My mother has now been discharged and will spend the weekend at home. She will be admitted to a different hospital on Monday.
The irony of the attempt by the hospital to discharge her on Wednesday is that the hemotologist hadn’t even reviewed her CBC panel. The CBC results are exactly the reason she was admitted in the first place.