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Predatory Hospital Billing: Dynamic Cost Shifting to the Uninsured

Published online by Cambridge University Press:  04 May 2004

Robert S. Walsh, M.D., is a cardiothoracic and vascular surgeon in private practice in Pikeville, Kentucky, and Clinical Professor of Cardiovascular and Thoracic Surgery at the Pikeville College School of Osteopathic Medicine. He is currently at work on a project comparing the business ethics of for-profit and not-for-profit hospitals


Over the past year, aggressive billing practices have been exposed at a number of hospitals in the United States. Despite the fact that a widower had paid $16,000 of his late wife's bill of $18,740, some 20 years after the incurrence of the bill a teaching hospital held a lien on his home for $40,000 in interest. Many years earlier the hospital had seized his bank account, and now the 77-year-old man was destitute. Only tremendous publicity caused the hospital to back down. That same week, another nonprofit teaching hospital reportedly drove a 25-year-old uninsured woman from New York City while dunning her for a $19,000 bill for a two-day stay for an appendectomy. In California, a patient was forced into bankruptcy in 2000 by a for-profit hospital from a day-and-a-half stay in the hospital that did not include any surgery but totaled $48,000 in hospital bills. These have become common stories as hospitals aggressively market, bill, collect, and foreclose, just like any other corporation. The uninsured are facing the brunt of the hospital industry's billing practices.

© 2004 Cambridge University Press

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