According to a 2019 study in the American Journal of Public Health, two-thirds of individual bankruptcy filings in the United States are tied to medical expenses — either because of the cost or lost work time.
Now, Washington has joined the federal government in trying to provide stability for consumers and increase transparency in how hospitals determine billing. The efforts are just one facet of a necessary overhaul to American health care.
Gov. Jay Inslee has signed House Bill 1272, which passed the Legislature this year and will require hospitals in Washington to provide clarity about their finances. The bill passed mostly along partisan lines, with all Democratic lawmakers from Southwest Washington voting in favor and all Republicans opposed.
The new law calls for increased reporting of financial information and patient demographic information. According to the Yakima Herald-Republic: “Supporters of the bill, including unions and patient advocates, say the legislation will give the public more information about how hospitals are spending their money and how that influences their decisions. Patient advocates say more information is needed to determine whether grants and other funds are being used that positively impact patient outcomes and meet the state’s health care needs.”
Critics often claim that hospitals are private organizations and that the law amounts to government meddling. But most hospitals are nonprofit organizations with tax-exempt status that requires them to provide community health programs and accept all patients. Legacy Salmon Creek has nonprofit status; PeaceHealth Southwest Medical Center is a not-for-profit organization — a similar status with minor distinctions.
Regardless of the distinctions, the finances of American health care too often are poorly designed for patients. Legislative solutions at both the federal and state level are needed to ensure that the system is working for the people who need it while making it tenable for providers to enter and remain in the market.
In December, as part of an appropriations bill, Congress approved the No Surprises Act to limit unexpected medical charges that can play havoc with a family’s finances. Rep. Jaime Herrera Beutler, R-Battle Ground, voted in favor as part of the bill’s bipartisan support.
Surprise bills typically occur when services are provided from outside a patient’s insurance network. As The New York Times explained: “Academic researchers have found that millions of Americans receive these types of surprise bills each year, with as many as 1 in 5 emergency room visits resulting in such a charge. . . . Some private-equity firms have turned this kind of billing into a robust business model, buying emergency room doctor groups and moving the providers out of network so they could bill larger fees.”
According to a survey from the Kaiser Family Foundation, two-thirds of American adults say they worry about unexpected medical bills — more than the number who worry about affording basic health care or household expenses.
Those concerns are warranted, as the details about bankruptcy filings indicate.
Piecemeal legislation is not the long-term solution. The United States spends more per capita on health care than any other nation yet ranks far down the list in terms of quality of care and patients outcomes.
But increasing transparency and outlawing surprise billings are a step in the right direction.