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Morning Notes

by ARLnow.com January 7, 2011 at 8:42 am 2,327 22 Comments

Uncompensated Care Costs Local Hospitals $102 Million — While discussing health care on a local TV interview show earlier this week, Rep. Jim Moran (D-Va.) cited a figure that seemed unbelievable. Moran said that in our congressional district alone, hospitals spend more than $100 million per year paying for those who don’t have insurance or can’t pay the bills. That figure appears to be accurate, says TBD’s Facts Machine.

Lawmakers Outline Priorities — Arlington’s state lawmakers discussed their priorities for the 2011 legislative session earlier this week. Proposals include eliminating the sales tax on food and replacing it with a higher income tax for the wealthy, increasing the state’s low cigarette tax and setting more stringent requirements on petition drives. More from the Sun Gazette.

Leaf Bag Collection Enters Final Week — If you still have bags of leaves lying around, now is the time to get rid of them. Arlington County’s final leaf bag collection will begin Monday. See the collection schedule here.

Non-Stop Bhangra at Artisphere — Organizers describe it as a non-stop party that feels like a scene from a Bollywood movie. San Francisco-based Non-Stop Bhangra will be rocking the house at Artisphere’s Saturday Night Dance Party this weekend. The party starts at 11:01 p.m. and features dance lessons, dance performances, live music sets and “DJs spinning an eclectic mix of bhangra, hip hop, reggae and electronica.” More from Arlington Arts.

Flickr pool photo by Chris Rief

  • Lou

    That $100 million number is no shocker. Especially if they are throwing in the operating and staff costs of some of the free clinics that the hospitals run just to support the population that lives without insurance. That’s providing immediate care as well as education and preventative medicine. Frankly I’m surprised the cost is not 5 times that.

    • LVGuy

      The hospitals don’t run free clinics, they just receive the donations that the hospital gives.

      • Lou

        Well, if the hospitals are paying for it (you use the euphemism “donations”), that is still the cost. I was just wondering if they include those costs in the figure.

        • LVGuy

          Sorry, just wanted to clarify. Most free clinics (including Arlington Free Clinic) are privately run. They receive donated services from Virginia Hospital Center, as well as from dozens of other medical facilities in the area.

    • Lacy Forest

      This just demonstrates that there is already publicly-funded health care, and in its most inefficient form. We would all be much better off if we would just admit that it is happening, that it has to happen due to our current health care delivery model, and then deal with it in a structured fashion. Right now, tremendous sums of taxpayer dollars are being spent providing indigent care with no plan.

      • el fat kid

        see but where you go wrong is speaking in rational and pragmatic terms…

  • R.Griffon

    And guess who pays for it? We all do. I love it when people say they don’t want any form of universal care (like in every other developed country) because their taxes will go up and it’ll cost them more. Guess what? You’re already paying that tax. You’re just paying it through higher medical bills and insurance premiums. And doing so with horrible efficiencies and plenty of middle men, which is why our per capita medical expenses are nearly double that of the rest of the industrial world without an accompanying increase in outcomes.

    • Burger

      Of course, the counter and more realistic view is that my taxes are going to go up and so will my premiums. Why should I want both?

  • LVGuy

    The $100 million figure is true but it’s a misrepresentation of the services they provide. Hospitals don’t have set price lists, and what they charge for a mammogram (or really any other service) for one person might be different for another person based on whether or not they have insurance or what insurance company they use. Insurance companies negotiate with hospitals to lower their prices. As a result, those without insurance actually end up paying (or owing) more for the same services someone with insurance receives.

    Of course, hospitals will quote the more expensive rates so they can write off more for tax purposes. In reality, though, those services may not actually cost them more than $20 million or possibly less.

    • Westover

      You MIGHT be able to cut the number in half, probably really just 25%, but the insurance companies do not get an 80% discount.

      • LVGuy

        On some procedures that might be true. But take a routine blood test (lipids, glucose, CBC, etc), one of the more common tests that Virginia Hospital Center provides. Three years ago VHC claimed that this cost $240. How much would my insurance pay? $75. That’s less than 1/3 of what VHC would charge me if I were uninsured. When it comes to donated services, hospitals are even more likely to jack up the price of the donated services. It’s standard practice.

        Sure, some procedures like surgeries are unlikely to be discounted at such a steep rate for insurance companies. Anesthesiologists are notoriously stingy when it comes to discounts, but these are services that the hospital rarely performs for free compared to blood tests, x-rays, mammogram, etc.

      • Uwe Reinhardt

        Self-payers are often billed at full list price, while insurance companies and Medicaid receive heavy discounts of at least 50% on most procedures. 80% is certainly not out of the question. Read this piece from Health Affairs to get a good idea of how inflated this $100m number probably is: http://content.healthaffairs.org/content/25/1/57.full

    • mehoo

      We don’t know whether the report accounted for this or not though.

      • LVGuy

        When hospitals donate services they claim a loss. That loss is whatever price they affix to certain services, so I’m assuming that the figure of $100 million accounts for that.

        • mehoo

          Right, you’re assuming. But we don’t know if the report adjusted for that. Probably not, but someone who isn’t as lazy as I am should look it up.

          • mt

            Considering there’s no link to the data cited and that the report doesn’t appear to be readily available on the internet, it is a reasonable assumption to believe that the $102m is based on undiscounted chargemaster rates.

            To believe otherwise would be to believe that hospitals act against their tax or tax-exempt status interests, voluntarily reducing their numbers to say that they provide LESS charity than the technical maximum amounts they are entitled to claim. Is that what you’re suggesting with this lazy skeptic act?

          • mehoo

            “it is a reasonable assumption to believe that the $102m is based on undiscounted chargemaster rates.”

            Or you could just assume nothing and just accept that we don’t know for sure.

            “To believe otherwise would be to believe that hospitals act against their tax or tax-exempt status interests…”

            No, it would be believing that the report’s authors simply accounted for this somehow by adjusting the numbers, that’s all.

          • Lou

            Or given that it came out of the mouth of a politician, you can assume it is skewed in the direction that most favors his political position on the issue. Come on people.

  • Arlwhenever

    Hospitals use rates that almost nobody actually pays in coming up with the $100 million uncompensated care estimate. If chrity cases were assumed to pay rates that are actually charged then the number would be no more than $50 million. INOVA hospitals alone pull in $2.2 billion in revenue annually. Assuming that’s a reasonable representation for the district total revenue, then the $50 million is about 2 percent of the total, which isn’t a whole lot higher than revenue loss from leakage (includes shoplifting) at many retail stores. Imagine if the government forced us all to buy approved food or approved clothing to compensate for losses at grocery stores and department stores. That’s the parallel for this horrendous health care bill.

  • JimPB

    A more accurate description: Those with health insurance and taxpayers are paying ARLCo hospitals for most of some $100 million in medical services/year that were not paid for by the patients who received the services.

    • LVGuy

      …and those services aren’t worth $100, but only a fraction of that amount.

  • Carmen

    Of course hospitals are going to charge the uninsured full price. I actually look at the claims my insurance company sends me after I go to my doctor. They always pay way less than 50% of what the doctor or labs charge them. Yet, they raise my monthly payments every year. At this point I have given them way more money than they have paid out for me.


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