Patients seeking care in hospital emergency rooms or recovering from surgery are being confronted by debt collectors, often posing as hospital employees, demanding payment, according to an April 25 article published in The New York Times.
Disguising debt collectors as employees in emergency rooms is one of the many aggressive strategies used by one of the nation’s largest collectors of medical debt, Accretive Health. Accretive Health’s website states that they are a “company with the sole focus of providing end-to-end Revenue Cycle execution for providers.” Accretive Health “increases access to care by bringing increased discipline to the revenue cycle.” Their website even claims that they boost patient access to health care.
The “increased discipline” they refer to includes badgering patients to pay outstanding bills and sometimes even requiring them to pay up front, before they receive any medical care. In some cases, the company’s workers have access to patients’ personal health information, a clear violation of federal privacy laws. The end result is that many patients are discouraged from seeking help for their health problems, which is the direct opposite of what hospitals are supposed to offer.
While the Times article focused on patients being harassed in hospitals in Minnesota, this trend is spreading nationwide. Accretive Health, based in Illinois, has contracts not only with the hospitals mentioned in the article, but with some of the largest hospital systems around the country, including Henry Ford Health System in Michigan and Intermountain Healthcare in Utah. Shortly before the article was published, Accretive announced it had won a contract to provide “revenue cycle operations” for Catholic Health East, which has hospitals in 11 eastern states, from Maine to Florida. Last year, Accretive reported $29.2 million in profit, up 130 percent from 2010.
Hospitals are struggling with a pile of unpaid bills. Community hospitals in the United States provided $39.3 billion in uncompensated care, up 16 percent from 2007. Yet, there is little wonder as to why patients cannot pay their bills. Health care is very expensive and fewer and fewer jobs offer workers any kind of health insurance benefits. The number of Americans who lack health care coverage is at an all-time high—46.6 million people. This is approximately 16 percent of the population. Nearly all the uninsured are workers or working-class families.
And while it is not unusual for hospitals to hire collection agencies to try to recoup some of the money owed, the past practice was for them to pursue patients after they had left their facilities. Now, the debt collectors are allowed inside, preventing patients from seeking care or not allowing them to leave after being treated until they pay up.
Capitalist system at fault
Although there are many factors contributing to rising health care costs—high-priced pharmaceuticals, more high-tech medical procedures, more elderly people who need greater medical care—the real source of the U.S health care crisis is capitalism.
In the capitalist system, health care is a commodity, like food, for-profit education, housing and so on. The need for health care is not seen as a basic human right, but rather as a source of profit for the owning class.
As long as health care is viewed as a commodity to be exploited for profit, the crisis will continue and worsen. Only a system that sees health care as a basic human right can provide a solution to the health care crisis.
