Free-care billing woes highlight health system's ills
THE ARTICLE "Hospitals probed on free-care billing" (Page A1, Feb. 11) highlights, once again, the gross incompetence Americans bring to the administration of their health system.
How much cerebral power would it take to stumble upon the idea that there ought to be a common fee schedule on which hospitals bill the state's free-care pool for healthcare rendered the uninsured? That fee schedule might be the same as Medicaid's or, because Medicaid is known to pay less than full costs, an average of the prices paid by private insurers, or something in between.
What went through the minds of the state's bureaucrats when they decided to let each hospital bill the free-care pool at that hospital's own preferred fees, and then to spend scarce resources on elaborate audits and inspector general's reports that uncover billing practices that may appear unseemly but probably are perfectly legal?
How is it that Americans cannot even get the simplest things right in their much-vaunted health system? The sheer administrative incompetence both the public and private sectors bring to the health system can explain why this system burns proportionately more resources on administration, and leaves more stakeholders dissatisfied, than does any other health system in the world.
UWE REINHARDT
James Madison professor of political economy
Princeton University 