Someone Has to Pay

A study by Citizen Action says the uninsured are being overcharged by hospitals

‘People don’t plan on getting sick and ending up in the hospital. So people in New York don’t realize how bad it is,” said Richard Kirsch of Citizen Action. Kirsch’s group released a study last Thursday (March 16) that says hospitals in New York, on average, charge uninsured patients double the actual cost of care. Locally, the study shows that in 2003, Ellis Hospital in Schenectady and St. Peter’s Hospital in Albany charged the uninsured three times the cost of care. In fact, the report shows that hospitals in the northeast part of the state in general had the greatest overcharge rates in the state.

“I think people are angry that the people who have the least are charged three to four times those with coverage,” said Assemblyman Peter Grannis (D-Manhattan). Grannis said that he has been moved by the people he has met who have been affected by overburdensome medical bills. He points to one man who is being assisted in overcoming his medical debt by the Empire Justice Center: “He had a heart operation after a heart attack, and got a $250,000 bill that had he been under the Empire Plan [insurance program] would have cost $50,000, and the medical team who did it refused to knock down their bill.” Insurance providers generally negotiate discounted rates of care for their clients.

On March 13, the Assembly approved a bill sponsored by Grannis that would require hospitals to provide discounts and assistance to the underinsured. However, Grannis noted that there needs to be further discussion of the bill: “What it is you get the discount off of? If it is off the $250,000, who cares if you get 10 percent off?” Both Grannis and Kirsch are hopeful the bill will make it through the Senate.

According to Christian Brown of the Empire Justice Center (a nonprofit advocacy group that helps people with debt reduction), hospitals are the largest holders of medical debt. She pointed to a survey her group did that says, “Eighty percent of people surveyed with medical debt owed hospitals, and of those folks who did indicate debt, 62 percent were not offered financial assistance of any kind.”

According to Brown, the people who need financial assistance are not getting it. “You have to figure out what programs are available, and it’s not easy. The real issue is there is no statewide process the hospitals have to follow [or] clear guidelines about who would be eligible, how hospitals [should] let people know about them.”

Hospital representatives don’t dispute the numbers contained in Citizen Action’s report, as the numbers were reported by the hospitals themselves. They do, however, claim that the numbers, which are from 2003, do not reflect improvements that have been made since. Elmer Streeter, a spokesman for St. Peter’s, said that before 2004 the hospital industry believed “that you had to bill people who did not have insurance at [full] charges, and this was a rule by Medicare.” Streeter said that later in 2004, the rule was clarified and hospitals were told they could provide discounts to the uninsured.

Said Streeter of the Citizen Action report, “The other thing that does not show up in the report [is] even back when there were no discounts, the charges were not what you ended up getting paid. Many people simply didn’t pay. It’s not a matter of some sort of windfall.”

Streeter pointed to his hospital’s numerous programs for those with an inability to pay. He said the hospital has financial advisors who try to get the uninsured coverage, and if they aren’t successful they try to qualify the uninsured for financial assistance through the hospital’s programs. According to Streeter, the physical bills from his hospital also alert patients to financial assistance for those who cannot pay. “Last year we spent $18 million on programs to care for the poor,” said Streeter.

Streeter insisted the true issue is the 46 million uninsured Americans. “The problem here is we have not addressed how to care for the uninsured,” he said.

Kirsch noted that his group did go back and take a look at 19 of the upstate hospitals surveyed in the last year, and that seven of them had improved. “It shows that some hospitals can do the right thing, but most hospitals aren’t, and voluntary standards don’t work. Particularly when hospitals are taking almost a billion dollars of taxpayer money to provide uncompensated care. It’s outrageous they expect to get this money with no strings attached.”

—David King

dking@metroland.net

Outer ripples of Abramoff corruption probe hit New York state, but cause little stir

Capital Region residents might do well to pay more attention to the fiasco surrounding corrupt Washington, D.C., lobbyist Jack Abramoff, as the political fallout has begun hitting close to home in recent months.

Last week, local congressman Rep. John Sweeney (R-Clifton Park) was one of several members of Congress to have his financial records pulled by a U.S. Department of Justice investigator involved with the Abramoff scandal. At the same time, the investigator pulled the records of several other prominent lawmakers with public connections to the disgraced lobbyist, including Rep. Tom DeLay (R-Texas) and Sen. Conrad Burns (R-Mont.), as well as those of a handful of Democrats with no known connection to him.

Sweeney has claimed to have no personal connection to Abramoff. When the scandal broke, he donated to charity about $2,000 in campaign contributions he had accepted from one of the lobbyist’s clients. (Sen. Hillary Clinton did the same.) However, Sweeney’s decision to attend a $2,000-per-person (the maximum limit for individual contributions) fund-raiser with pharmaceutical industry lobbyists at a Utah ski lodge a week after donating the money has caused editorial and letters-to-the-editor pages alike to question his sincerity when it comes to wanting to restore public faith in congressional lawmakers.

While the critical eye cast on Sweeney by the mainstream media in the wake of this news turned more sympathetic recently when the congressman spent several days in the hospital for blood-pressure-related problems, the extent of his connections with Abramoff is still uncertain—a fact that Sweeney’s rival, Democrat Kirsten Gillibrand, has repeatedly pointed out.

Meanwhile, the specter of the Abramoff scandal looms large over New York’s decision-making process regarding voting machines. According to the New York State Commission on Lobbying, Abramoff’s former lobbying firm, Greenberg Traurig Inc., spent more than $275,000 pushing for voting machine manufacturer Diebold to gain a foothold in the governor’s office, the New York State Board of Elections, the New York City Board of Elections and the Legislature.

Diebold’s former CEO, Walden O’Dell, who famously declared in 2003 that he was “committed to helping Ohio deliver its electoral votes to the president,” resigned last year amid reports that the company was being investigated for fraud and various other illegal activities. In addition to numerous reports regarding the ease with which Diebold machines’ vote tallies can be manipulated, more than 20 percent of the machines failed or otherwise incorrectly reported vote results last year in one of the largest tests conducted on the electronic machines.

Nevertheless, many of New York’s state and local lawmakers appear to be leaning toward using similar machines, rather than the more reliable optical-scan balloting machines—a situation that, according to many voters-rights groups, indicates the level of influence lobbyists like Abramoff’s firm have been able to buy in New York.

Now, as headlines regarding the Abramoff scandal fade from the front pages of mainstream newspapers and evening news programs, the calls for reform put out by Sweeney and other federal lawmakers have also faded away. Although a yet-to-be-introduced Senate bill would prevent lawmakers from accepting meals and gifts from registered lobbyists, the bill’s counterpart in the House—originally an expansive prohibition on gifts from lobbyists—has diminished to a simple requirement for more disclosure. With federal and state lobbying groups already saying they don’t expect these ramifications of the Abramoff scandal to affect the way the way they go about their days, Capital Region residents may not be too far off base in wondering how the scandal will affect the way they go about theirs.

Calls to Sweeney’s office were not returned.

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