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News Advocacy Group Probes HCA's Treatment Of The Uninsured The Associated Press NASHVILLE, Tenn. - Shirley Kuybus says she walked into HCA's Central Florida Regional Medical Center in November bent over in pain, unable to eat, sleep or work. She desperately needed gallbladder surgery, but before the doctor could operate, the hospital told the uninsured Denny's restaurant cook that she would have to pay at least $10,000 up front. ``No money, no operation,'' Kuybus said she was told. ``I didn't expect to get it free, but I didn't expect to get charged that much,'' Kuybus, 63, said in a telephone interview from her Sanford home. ``I think they really took advantage of me. I had to have the operation.'' An advocacy group is investigating accusations that Nashville-based HCA, the nation's largest for- profit hospital chain, price-gouges uninsured patients, demands they make upfront payments and takes legal action against those who have no means of paying. HCA operates 15 hospitals across the Tampa Bay area - including Brandon Regional and South Bay in Hillsborough County. There are 13 others within the company's West Florida Division, including a pair in Pasco County: Community Hospital of New Port Richey and Regional Medical Center Bayonet Point; and four in Pinellas County: Edward White Hospital, St. Petersburg General Hospital, Northside Hospital and Heart Institute, and Largo Medical Center. ``HCA appears to be engaging in the most deplorable and egregious behavior we've ever seen with senior citizens and working-class folks,'' said K.B. Forbes, founder of the Los Angeles-based Consejos de Latinos Unidos. ``It is time they halt this immoral behavior.'' Federal law requires hospitals to provide care for all patients who visit an emergency room, regardless of their ability to pay and citizenship. Typically, hospitals only charge the working poor full retail, while health plans bargain for discounts for patients they insure and the federal government covers the poorest and elderly Americans. Hospitals increasingly seek payment up front from uninsured patients and aggressively try to collect money after they go home because they want to recoup some of their costs. In 2001, hospitals provided $21.5 billion in uncompensated care, according to the American Hospital Association. Tenant Chain Sued Last year, Forbes' organization sued Tenet, the nation's second-largest hospital system, for allegedly price-gouging Latino patients. Under pressure from the advocacy group and the federal government, Tenet said last month that it will seek regulatory approval for discounts to uninsured patients and will stop taking legal action against those who have no means of paying their bill. About 41 million people in the United States were uninsured in 2001, according to a Census Bureau report released in the fall - 1.4 million more than the previous year. HCA spokesman Jeff Prescott said HCA is working on a new policy regarding payments from uninsured patients, but creating a discounted payment or charity care plan is tough because of Medicare rules ``The desire and the general idea is easy,'' Prescott said. ``Finding a structure that is workable within the regulatory framework is difficult.'' But Arthur Levin, a spokesman for the New York-based Center for Medical Consumers, said forcing patients to prepay for surgeries is ``slimy and sleazy. It highlights the warts of our for-profit health care system,'' he said. Forbes said he doesn't want a free ride for the uninsured; he just wants hospitals to be fair. He said they should be charged a rate comparable to what managed care plans pay. If Kuybus had been insured, the hospital would have gotten about $6,000 for the surgery, while Medicare would have paid about $4,500, said Diane Rowland, executive director of the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. Almost All Savings Spent Instead, Kuybus emptied nearly all her life savings, gave the hospital $15,000 and had her gallbladder removed in December. She eventually got the charge reduced to $9,500, but the hospital kept most of the rest to pay for emergency room visits before the procedure, even though she had worked out payments. She now works a third night a week at Denny's to pay for insurance. ``In my case I had the money, but if it happened again, I'd be lost,'' she said. From: |
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