Letter: Stay vigilant to ensure health care system serves citizens

Graphic by Lori Deaton

[In response to the letter, “Will HCA Healthcare Serve Low-income Patients?” Jan. 9, Xpress]:

HCA’s response that “HCA has one of the most generous charity care policies in the industry” fails to address Ms. [Mary Ann] LaMantia’s concerns of the impact of this sale on individuals with insurance coverage through Medicaid or Medicare. These government-sponsored insurance coverage programs understandably seek to contain costs by limiting reimbursement to providers. We need to stay vigilant, as health care in our region becomes less of a public good and a means for increasing shareholder wealth. Charity care is often limited to individuals without insurance.

This generous charity care policy also may not be as good as it sounds: In a recent meeting with the Asheville Area Chamber of Commerce, Dr. Ron Paulus noted that Mission had changed its charity care policy to be less generous, when they discovered that it actually negatively impacted individuals seeking coverage through health insurance exchanges. HCA also notes in their response that they have “interest-free payment [arrangements].”

However, without an insurance provider to negotiate a reduced rate (whether private or government-sponsored), individuals without insurance are often charged the “rack rate” for services, which includes made-up charges through their “chargemaster” rate schedule. If you find yourself in this position, be sure to ask the hospital to justify how that charge relates to actual costs of provision of services.

I concur with Ms. LaMantia’s sentiment that local governments and others are “salivating” over the prospect of the proceeds of this sale. The population of Western North Carolina will not magically change if and when this sale occurs; we will still have low- and middle-income people with no health insurance who may get hit with exorbitant medical bills. We need leadership in our region to continue to advocate, agitate and educate to ensure that the health care system serves its citizens.

— Kae Livsey
Master’s in public health, Ph.D., R.N.

Editor’s note: The sale of Mission Health to HCA Healthcare was completed on Friday, Feb. 1.


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