Here’s some real health care reform: Civil Gideon for indigent patients
It's great that many states have charity care programs to help indigent patients receive urgent medical care when they can't afford it. Too bad many patients either don't know about these programs or are put through the ringer trying to make use of them, as this article explains:
When Barbara Gamba went to Valley Medical Center in May 2007 with a gallbladder attack, she told everyone within earshot that she had no job and no health insurance.
A Valley Medical financial counselor told the Renton woman at the time not to worry; if she couldn't pay for her treatment, the hospital would chalk it up as charity care.
But it didn't do that.
A month later, Gamba received a statement for the full cost of her gallbladder surgery: $18,410. She immediately sent the Renton hospital a letter explaining that she was broke, and again requested a charity write-off. Valley Medical then knocked off 30 percent - or $5,469 - from her bill but insisted she pay the rest.
"Had I known that I'd owe this amount, I would have kept my gallbladder and gone home," Gamba, now employed as a counselor for Senior Services, wrote back. "I am begging for your compassion."
Gamba shouldn't have had to beg.
Under Washington law, Gamba and other patients with annual incomes below the poverty level - $10,400 for a single person - are not required to pay anything at any licensed medical or psychiatric hospital in the state.
Many patients file for bankruptcy or have to somehow scrape up money they simply don't have to pay bills that, under the law, they are not even obligated to pay. Oddly, those who are able to get a poverty or health care lawyer to help them don't have the same trouble. Hmmm... Civil Gideon anyone?
As policymakers consider what good health care reform is going to look like, they must consider how to provide better resources for indigent patients. This means access to quality health care services as well as to information about their legal rights in the health care system.
Tom Daschle and the rest of the Obama health care team are busy setting priorities for health care reform, asking ordinary citizens about their experiences in the health care system to get a feel for what needs to be done. I hope they ask people like Barbara Gamby what they think.