Now
Available from
CounterPunch for Only $11.50 (S/H Included)
Today's
Stories
January 7, 2004
Ramon Ryan
Small
Victories and Long Struggles: the 10th Anniversary of the Zapatista
Uprising
January 6, 2004
Dave Lindorff
RNC
Plays the Hitler Card: MoveOn Shouldn't Apologize for Those Ads
Ron Jacobs
Drugs
in Uniform: Hashish and the War on Terrorism
Josh Frank
Coffee and State Authority in Colombia
Doug Giebel
Permanent Bases: Leave Iraq? Hell No, We Won't Go
John Chuckman
Sick Puppies: David Frum's New Neo-Con Manifesto
Rannie Amiri
The Politics of the Iranian Earthquake
John L. Hess
A Record
to Dissent From
Thacher Schmid
A Cheesehead's Musings on the Sunday NYT
David Price
"Like
Slaves": Anthropological Thoughts on Occupation
January 5, 2004
Al Krebs
How
Now Mad Cow!
Kathy Kelly
Squatting
in Baghdad's Bomb Craters
Jordy Cummings
The Dialectic of the Kristol Family: Putting the Neo in the Cons
Fran Shor
Mad Human Disease: Chewing the Fat Down on the Farm
Fidel Castro
"We Shall Overcome": On the 45th Anniversary of the
Cuban Revolution
Gary Leupp
North
Korea for Dummies
January 3 / 4, 2004
Brian Cloughley
Never
Mind the WMDs, Just Look at History
Vice Admiral Jack Shanahan
The Wrong War at the Wrong Time
William Cook
Failing to Respond to 9/11
Glen Martin
Jesus
vs. the Beast of the Apocalypse
Robert Fisk
Iraqi Humor Amid the Carnage
Ilan Pappe
The Geneva Bubble
Walter Davis
Robert Jay Lifton, or Nostalgia
Kurt Nimmo
Ashcroft vs. the Left
Mike Whitney
The Padilla Case
Steven Sherman
On Wallerstein's The Decline of American Power
Dave Lindorff
Bush's Taiwan Hypocrisy
William Blum
Codework Orange!
Mitchel Cohen
Learning from Che Guevara
Seth Sandronsky
Mad Cow and Main Street USA
Bruce Jackson
Conversations with Leslie Fiedler
Standard Schaefer
Poet Carl Rakosi Turns 100
Ron Jacobs
Sir Mick
Adam Engel
Hall of Hoaxes
Poets' Basement
Jones, Albert & Curtis
January 2, 2004
Stan Cox
Red Alert
2016
Dave Lindorff
Beef, the Meat of Republicans
Jackie Corr
Rule and Ruin: Wall Street and Montana
Norman Solomon
George Will's Ethics: None of Our Business?
David Vest
As the Top Wobbleth
January 1, 2004
Randall Robinson
Honor
Haiti, Honor Ourselves
David Krieger
Looking
Back on 2003
Robert Fisk
War Takes an Inhuman Twist: Roadkill Bombs
Stan Goff
War,
Race and Elections
Hammond Guthrie
2003 Almaniac
Website of the Day
Embody Bags
December 31, 2003
Ray McGovern
Don't
Be Fooled Again: This Isn't an Independent Investigation
Kurt Nimmo
Manufacturing Hysteria
Robert Fisk
The Occupation is Damned
Mike Whitney
Mad Cows and Downer George
Alexander Cockburn
A Great Year Ebbed, Another Ahead
December 30, 2003
Michael Neumann
Criticism
of Israel is Not Anti-Semitism
Annie Higgins
When
They Bombed the Hometown of the Virgin Mary
Alan Farago
Bush Bros. Wrecking Co.: Time Runs Out for the Everglades
Dan Bacher
Creatures from the Blacklight Lagoon: From Glofish to Frankenfish
Jeffrey St. Clair
Hard
Time on the Killing Floor: Inside Big Meat
Willie Nelson
Whatever Happened to Peace on Earth?
December 29, 2003
Mark Hand
The Washington
Post in the Dock?
David Lindorff
The
Bush Election Strategy
Phillip Cryan
Interested Blindness: Media Omissions in Colombia's War
Richard Trainor
Catellus Development: the Next Octopus?
Uri Avnery
Israel's
Conscientious Objectors
December 27 / 28, 2003
Alexander Cockburn
A
Journey Into Rupert Murdoch's Soul
Kathy Kelly
Christmas Day in Baghdad: A Better World
Saul Landau
Iraq
at the End of the Year
Dave Zirin
A Linebacker for Peace & Justice: an Interview with David
Meggysey
Robert Fisk
Iraq
Through the American Looking Glass
Scott Burchill
The Bad Guys We Once Thought Good: Where Are They Now?
Chris Floyd
Bush's Iraq Plan is Right on Course: Saddam 2.0
Brian J. Foley
Don't Tread on Me: Act Now to Save the Constitution
Seth Sandronsky
Feedlot Sweatshops: Mad Cows and the Market
Susan Davis
Lord
of the (Cash Register) Rings
Ron Jacobs
Cratched Does California
Adam Engel
Crumblecake and Fish
Norman Solomon
The Unpardonable Lenny Bruce
Poets' Basement
Cullen and Albert
Website of the Weekend
Activism Through Music
December 26, 2003
Gary Leupp
Bush
Doings: Doing the Language
December 25, 2003
Diane Christian
The
Christmas Story
Elaine Cassel
This
Christmas, the World is Too Much With Us
Susan Davis
Jinglebells, Hold the Schlock
Kristen Ess
Bethlehem Celebrates Christmas, While Rafah Counts the Dead
Francis Boyle
Oh Little Town of Bethlehem
Alexander Cockburn
The
Magnificient 9
Guthrie / Albert
Another Colorful Season
December 24, 2003
M. Shahid Alam
The Semantics
of Empire
William S. Lind
Marley's
List for Santa in Wartime
Josh Frank
Iraqi
Oil: First Come, First Serve
Cpt. Paul Watson
The
Mad Cowboy Was Right
Robert Lopez
Nuance
and Innuendo in the War on Iraq
December 23, 2003
Brian J. Foley
Duck
and Cover-up
Will Youmans
Sharon's
Ultimatum
Michael Donnelly
Here
They Come Again: Another Big Green Fiasco
Uri Avnery
Sharon's
Speech: the Decoded Version
December 22, 2003
Jeffrey St. Clair
Pray
to Play: Bush's Faith-Based National Parks
Patrick Gavin
What Would Lincoln Do?
Marjorie Cohn
How to
Try Saddam: Searching for a Just Venue
Kathy Kelly
The
Two Troublemakers: "Guilty of Being Palestinians in Iraq"
December 20 / 21, 2003
Alexander Cockburn
How
to Kill Saddam
Saul Landau
Bush Tries Farce as Cuba Policy
Rafael Hernandez
Empire and Resistance: an Interview with Tariq Ali
David Vest
Our Ass and Saddam's Hole
Kurt Nimmo
Bush
Gets Serious About Killing Iraqis
Greg Weiher
Lessons from the Israeli School on How to Win Friends in the
Islamic World
Christopher Brauchli
Arrest, Smear, Slink Away: Dr. Lee and Cpt. Yee
Carol Norris
Cheers of a Clown: Saddam and the Gloating Bush
Bruce Jackson
The Nameless and the Detained: Bush's Disappeared
Juliana Fredman
A Sealed Laboratory of Repression
Mickey Z.
Holiday Spirit at the UN
Ron Jacobs
In the Wake of Rebellion: The Prisoner's Rights Movement and
Latino Prisoners
Josh Frank
Sen. Max Baucus: the Slick Swindler
John L. Hess
Slow Train to the Plane
Adam Engel
Black is Indeed Beautiful
Ben Tripp
The Relevance of Art in Times of Crisis
Michael Neumann
Rhythm and Race
Poets' Basement
Cullen, Engel, Albert & Guthrie
Hot Stories
Alexander Cockburn
Behold,
the Head of a Neo-Con!
Subcomandante Marcos
The
Death Train of the WTO
Norman Finkelstein
Hitchens
as Model Apostate
Steve Niva
Israel's
Assassination Policy: the Trigger for Suicide Bombings?
Dardagan,
Slobodo and Williams
CounterPunch Exclusive:
20,000 Wounded Iraqi Civilians
Steve
J.B.
Prison Bitch
Sheldon
Rampton and John Stauber
True Lies: the Use of Propaganda
in the Iraq War
Wendell
Berry
Small Destructions Add Up
CounterPunch
Wire
WMD: Who Said What When
Cindy
Corrie
A Mother's Day Talk: the Daughter
I Can't Hear From
Gore Vidal
The
Erosion of the American Dream
Francis Boyle
Impeach
Bush: A Draft Resolution
Click Here
for More Stories.
|
January
7, 2004
Uncharitable Care
How
Hospitals are Gouging and Even Arresting the Uninsured
By THE STAFF OF DEMOCRACY
NOW!
What do the Emir of Kuwait and the working poor
of the United States have in common? Not much, except when it
comes to paying for health care in the United States. They all
pay the highest price: up to 500% more than the hospital receives
from insured patients.
That's because hospitals negotiate discounts
with big institutions like insurance companies, HMOs or the government
that require payment of only a fraction of the listed charges.
Those institutions have substantial bargaining power and can
guarantee hospitals a certain number of patients. Uninsured people,
on the other hand, have no bargaining power and are left to fend
for themselves once they get their bills.
Jennifer Kankiewicz was rushed to New
York's Beth Israel Hospital in July 2002 for an emergency appendectomy
and was hospitalized for two days. "I waited through a day's
worth of not being able to get out of bed because I didn't have
health insurance," recalls Kankiewicz. "The next day,
a friend drove me to the hospital in an emergency and we went
to the closest hospital we knew of."
Kankiewicz had an emergency appendectomy.
"They provided great service," she says. The hospital
"reassured me that I could apply for Medicaid assistance.
So I thought, maybe Medicaid would help me with the $24,000 that
it cost me."
Though Kankiewicz is poor, she was not
poor enough. She was denied Medicaid assistance because she makes
$19,000 a year. In order to qualify for Medicaid, Kankiewicz
either needed to be pregnant, disabled or earn less than $350
a week. Though she was able to convince her surgeon to slightly
reduce the charges, she still faces over $19,000 in hospital
bills, more than her annual salary. She says she is being billed
by six separate billing groups and, unlike the big insurance
companies; Kankiewicz has no negotiating power with the hospital
or its collection agencies.
"It's like sending a guppy out to
the sharks," says Elisabeth Benjamin, the supervising attorney
of the Health Law Unit at the Legal Aid Society in New York.
"It's just not fair."
Several states operate a funding pool
for hospitals to offset the money they spend on charity care
as well as bad debt. In New York, these funds total almost $1
billion a year.
Benjamin is the author of a new Legal
Aid report called "State Secret: How Government Fails To
Ensure That Uninsured And Underinsured Patients Have Access To
State Charity Funds." The report alleges that none of the
22 hospitals surveyed in New York City have a process that would
let poor or uninsured patients apply for the hundreds of millions
of dollars in state government funds intended to help pay for
hospital care for the needy, despite the fact that they are all
receiving between $4-$60 million annually in charity care funds
from the state. As a result, patients who are uninsured and have
limited financial resources are forced to pay inflated prices
for their care.
"An average consumer that might
want to call a hospital and find out what the charity care policy
is, forget it," says Benjamin. "What we found was at
all 22 [hospitals], no one had a way to actually get the state
money applied to your case."
In Kankiewicz's case, according to Benjamin,
Beth Israel receives $28 million a year for charity or bad debt
cases. But rather than establishing a process to inform patients
about applying for this money, Beth Israel made Kankiewicz go
through the process of applying for Medicaid.
"I could have told Jennifer in 30
seconds, she wasn't going to be eligible for Medicaid,"
says Benjamin. "For her to have gone to a fair hearing [on
Medicaid eligibility] on her own was a waste of time."
Kankiewicz says that when she initially
spoke to the collections department at Beth Israel, they asked
her why she chose the most expensive hospital if she was uninsured.
"Honestly, I didn't understand that I was a consumer, that
I had to shop," Kankiewicz says. "I wasn't making a
decision at the time. I rushed to the hospital that I knew where
it was."
Like Kankiewicz, many uninsured patients
end up with huge medical bills and no way of paying them. Hospitals
then hound them for payment using collection agencies and lawyers,
who employ such methods as filing lawsuits, slapping liens on
homes, seizing bank accounts and garnishing wages to extract
payments. Some hospitals now rank among America's most aggressive
debt collectors.
"[Patients] don't know they have
been sued because the collection attorneys and the collection
agent hired by the hospitals are voracious," says Benjamin.
"They claim to serve people, but in fact they have never
served anybody with court papers. The next thing my clients know,
their bank accounts have been taken."
But for some people, it can get worse
than that.
A Return to Debtors
Prisons
Hospitals in several states have actually
had patients arrested and jailed if they are unable to pay their
debts. This legal tactic is chillingly known as body attachment.
"Body attachment is basically a
warrant for arrest," says Claudia Lennhoff, executive director
of Champaign County Health Care Consumers in Illinois. She says
that if a patient misses a court date, that they may not even
know they have, the attorneys for the hospitals or collection
agencies can ask the judge to issue a warrant for the patient's
arrest.
"They can go out immediately and
find that person or it can just kind of be out there and then
if the person gets pulled over, for example, for having a taillight
out or speeding or something, it pops up, and then shows a warrant
for arrest and the person gets brought in, and then they get
incarcerated," says Lennhoff.
Take the case of Jim Bean, a musician
in Urbana, Illinois. More than a decade ago, he received treatment
at the Carle Foundation Hospital, the primary teaching hospital
of the University of Illinois at Champaign-Urbana, for a gunshot
wound after a failed suicide attempt. He attended 13 court dates
to answer to his $7,718 hospital bill. But then Bean missed a
hearing, which he says he did not know was scheduled. The hospital
asked the court for an arrest warrant.
"They put out this body attachment
that I found out about the next day. I went and turned myself
in," recalls Bean. "I went to find out what was going
on, and they told me to go across the street to the county sheriff's
office where I turned myself in. I was jailed, and I was put
into general population at the satellite facility here until
my brother could come up with 10% of $3,500 to bail me out of
jail."
Bean says the next time he went to court,
the attorneys for Carle Hospital asked that Bean's bail money
be applied toward his debt to the hospital. The judge approved
the request. "It was just a really quick way for them to
collect $350," he says. "I had no say in that."
In an interview with Democracy Now!,
Robert Tonkinson, chief financial officer for Carle Foundation
Hospital, said the hospital would not end its practice of having
patients arrested.
"We are exercising more review,
and more care and more direction over that practice," says
Tonkinson. But he says, "The reason we're not willing to
say that we'll never, never use that practice again is because
we do feel a very strong obligation to be a good steward of the
resources we have." He adds that sometimes having people
arrested is "the only option left in order to get the information
we need to see if these people qualify for our charity programs
or in assistance in other ways is to pursue that process."
Bean has been dealing with his debt to
Carle Hospital for more than 12 years. He says he has made payments
totaling $1,340. "When I started making those payments,
my bill was $7,718.23," he says. "My bill today is
$10,620.46. None of the money that I have paid has been applied
to the debt whatsoever, it's all in interest charges."
Legal Aid's Benjamin says that Bean's
case is part of a national trend. "In New York State, for
example, the collection agents charge 9% interest," she
says. "So, even though the federal interest rate is 1%,
and most people can get mortgages for 6%, the hospital industry
is charging 9%, at least, on average."
Lennhoff of the Champaign County Health
Care Consumers says that practices like arresting people who
can't afford to pay the exorbitant costs of health could have
far reaching implications. "It creates a bad dynamic in
our community, where people become very afraid of getting healthcare
because they fear that they will be jailed if they cannot pay
the bill," she says. "They are treated as a criminals
and that's outrageous."
Democracy Now!
is a daily national radio/TV newshour. Amy Goodman, Jeremy Scahill,
Sharif Abdel Kouddous and Mike Burke compiled this report. Visit:
www.democracynow.org.
Weekend
Edition Features for January 3 / 4, 2004
Brian Cloughley
Never
Mind the WMDs, Just Look at History
Vice Admiral Jack Shanahan
The Wrong War at the Wrong Time
William Cook
Failing to Respond to 9/11
Glen Martin
Jesus
vs. the Beast of the Apocalypse
Robert Fisk
Iraqi Humor Amid the Carnage
Ilan Pappe
The Geneva Bubble
Walter Davis
Robert Jay Lifton, or Nostalgia
Kurt Nimmo
Ashcroft vs. the Left
Mike Whitney
The Padilla Case
Steven Sherman
On Wallerstein's The Decline of American Power
Dave Lindorff
Bush's Taiwan Hypocrisy
William Blum
Codework Orange!
Mitchel Cohen
Learning from Che Guevara
Seth Sandronsky
Mad Cow and Main Street USA
Bruce Jackson
Conversations with Leslie Fiedler
Standard Schaefer
Poet Carl Rakosi Turns 100
Ron Jacobs
Sir Mick
Adam Engel
Hall of Hoaxes
Poets' Basement
Jones, Albert & Curtis
Keep CounterPunch Alive:
Make
a Tax-Deductible Donation Today Online!
home / subscribe
/ about us / books
/ archives / search
/ links /
|