UVa Health System, “I wish I knew how to quit you”.
Ok, I made that quote up. Some may get the reference. Anyway, there has been a major brouhaha about the UVa Health System suing patients to get paid. I will give my opinion in a minute but here is the quote from this article:
UVA Health System, which sues thousands of patients each year, seizing wages and home equity to collect on overdue medical bills, said Friday it would increase financial assistance, give bigger discounts to the uninsured and “reduce our reliance on the legal system.”
So, they are cutting back their aggressiveness because they were called out on it. This doesn’t mean they will quit but just need to cool it for a while.
These are the questions and thoughts flying back and forth in my brain:
- I like the UVA Health System as far as quality of care and refer all my tough patients there.
- Shouldn’t “customers” have to pay for things?
- Maybe they would pay for things if these things were reasonable in cost and equal to what the insurers actually pay?
- Some people have terrible insurance with massive deductibles and are getting screwed by the insurers.
- Why is that the hospitals fault? Why should they suck up the debt?
- Why can’t we get the REAL prices on things and move back to old “major medical” insurance plants of the 70s?
As you can see, I have no answers. That being said, it is easy to make the big hospital out as evil. I just don’t think it is that simple.
Get our awesome newsletter by signing up here. We don’t give your email out and we don’t spam you.
One has to decide if healthcare is a basic need that all legal residents of the USA should have access to or whether it is not.
If yes, it should be treated like infrastructure, law enforcement or other items deemed important enough for all to be funded by taxes. Such an approach focuses on the common good
If no, then healthcare businesses will continue to focus on profits (for a relative few) rather than on the common good.
Both broad approaches have innate imperfections and with much to complain about
The ridiculousness of “not-for-profit” designations, the absurd inequality of wealth between the executive pay of the UVA system vs the poor patients it sues, the building programs where healthcare facilities look like fancy art museums and unaffordable care (including insuin) leading to preventable deaths are all a byproduct of “no”. It doesn’t happen in any other westernized industrialized country.
There are plenty of healthcare models around the world we can learn things from. IMO we have to get over the knee jerk reaction that so many have, that government is always bad. Government done well is good for the common good. Government done bad sucks but it’s usually because of corrupt or inept personal, not because the mission is flawed. Profit driven capitalistic enterprises are very good for many things- building widgets, non-life threatening services etc but it only benefits those who can pay to play. As a physician my personal moral compass prefers a healthcare system that priorities the common good vs a profit driven exclusionary system.
Btw, I’m a fan of DPC as an “add-on” business model and I’m happy to see it growing in popularity. I think it’s great for those who can afford it and I think it’ll exert downward price pressure. But, it doesn’t work for everyone and therefore can’t be the default or only option for primary care. Also, DPC patients still need care outside of the DPC offices for big ticket items (trauma, cancer, myocardial infaction etc) therefore it doesn’t replace the need for insurance.
It’s not so much that big hospitals are evil per se, but are part of a large evil system. Fwiw, I think it’s those policy makers who have influence over the system and don’t prioritize the common good who are the most vile. Yeah, yeah I get it- those corrupt policy makers are part of the problem with government.
Good thoughtful post JRDO. My view is that any governmental system will grow its own demand while putting price and regulatory pressure on any non-government system, ultimately leading to the latter’s demise. That is what we are seeing via Medicare. I wish it weren’t so, but anyone considering a career in medicine should resign themselves to being a government drone. I wish I had the imagination long ago to foresee this, but alas…
It’s fun to charge these windmills, but the long term outcome is inevitable.