I’m spending this month down among Boston’s largest cluster of hospitals. One thing that I’ve noticed is that the people who do the work are completely disconnected from the people who collect the money.
I sat with a group of medical students looking at some insurance data. There were 12,000 claims for one patient. I said “What a disaster for the insurance company.” The students were bewildered. They had been thinking only about the hardship for the family and patient, i.e., bringing someone in for 12,000 procedures, medications, tests, etc.
A suburban friend’s cleaning woman came into one of these hospitals, told them she had no job, and they delivered her baby for free. One of the beauties of the U.S. system is that nobody can say what the value of this service was or what it would have cost if she had tried to pay. (For example, see “The Real Cost Of Giving Birth In The U.S.” (HuffPost) in which you won’t actually learn either what it costs or what the hospitals charge!)
A friend of a friend is married to a Honduran. Every time one of her extended family members is 8 months pregnant she will come to Boston. After labor begins, “they drop her off and drive away; that way nobody can ask for her address or insurance information.”
[Aside from the free hospital services, what’s the value in this system? The US Govt offers permanent residence to anyone whose child is a citizen at least 21 years old (see this helpful federal web page on the subject). In most states permanent residents are eligible for nearly all welfare benefits. Thus the “anchor baby” eliminates the need to save for retirement and the parent can spend 100 percent of his or her income prior to retirement.]
Given that doctors don’t make too much use of past test results, and therefore there is no medical value in supplying a real name, I’m surprised at the horror stories that we sometimes read in the media about hospitals chasing down former patients for non-payment of bills. At least in urban environments, how was it that any hospital ever gets the full name, address, and Social Security number of an uninsured patient? Why aren’t Americans simply saying “I’m undocumented” when asked invasive personal questions by a hospital administrative staffer?