This is a story about Jerry Marcus and Gary Fennessy. I don't know Jerry or Gary, but by the end of this editorial, you will know their points of view. Jerry and Gary are two individuals carrying on a disagreement being played out at hospitals across the country. Jerry is an uninsured patient who claims that the hospital that cared for him was more interested in shaking him down for full charges than treating him for his ailment. Gary is a financial officer at the same hospital who claims that his staff did everything it could to assist Jerry, but Jerry's reluctance to disclose his financial condition made it difficult to determine if he qualified for special financial assistance.
Modern Healthcare is neutral in this fight, taking no position on whose account of the events, Jerry's or Gary's, is accurate. But in an effort to serve our readers, and despite pressure from the hospital not to do so, we made the editorial decision to run Jerry's letter to the editor and Gary's response to his accusations in this issue. They appear on p. 22.
The hospital argued that Jerry's letter shouldn't appear in print because it makes false claims against the hospital. Letters, unlike our staff-written news or feature stories, are statements of a person's opinion or the person's recollection of an event. As we mentioned in this space in our June 28 issue, the Modern Healthcare letters section has become a true marketplace of ideas where people from all segments of the healthcare industry, including consumers, can share their thoughts with readers no matter how controversial. We do reserve the right not to run letters that we deem to be offensive or inappropriate. The section is designed to foster debate on the hot topics of the day. And none is hotter right now than how hospitals bill the poor for their care. Just ask the five high-profile hospital executives who testified before Congress on this very issue. They appeared on the cover of our June 28 edition.
We also are true believers in the First Amendment, and we are loath to censor someone's opinion, no matter how uncomfortable that opinion may make us or our readers. Additionally, I've worked at Modern Healthcare since 1987, and hardly a week has gone by without me hearing our publisher, Chuck Lauer, say, "Where's the patient in all of this? No one is talking about the patient!" Chuck has consistently expressed his dismay that, in many of the industry discussions he participates in, patients are given short shrift.
Per standing policy, we shared Jerry's letter with Gary's hospital before publication, offering the hospital an opportunity to respond in print to the letter. The hospital at first resisted, fearing that any response, no matter how thoughtful, would make the hospital appear heavy-handed or uncaring. But then something we consider miraculous happened. Gary responded directly to Jerry's accusations with both barrels. Gary told Jerry that he was full of something other than just tubes and needles.
Gary said what's on the minds of hospital executives everywhere. I don't know Jerry's personal financial status, but some patients with the means to pay their bills are using the current uninsured billing controversy as a smoke screen to avoid squaring up financially with hospitals for their care. CEO after CEO we talk to say the same thing. Lawyers, doctors, clergymen, bankers, businessmen, you name it, are refusing to pay their copayments, deductibles and balances. Each time we hear this, we ask the CEO to write a letter or commentary about it. Each time they politely refuse for the same reason Gary's hospital initially resisted. They think they would come off looking like the bad guys. Consequently, that side of the billing controversy isn't being told. Until now. And that's what will make Gary a hero, albeit reluctantly, in healthcare finance circles.
In fact, that's a problem that has plagued the hospital industry for years. Hospitals act as if they're ashamed to post a modest profit. If they act as if making a modest profit is wrong, then others will think it's wrong, too, and will try to take it away. The situation unfortunately is complicated by some hospitals making excessive profits or some hospital executives making excessive salaries. Those situations make it more difficult for hospitals to argue that they are doing everything they can for the poor.
Jerry also is a hero. His frustration with byzantine hospital pricing and billing practices is representative of how many patients feel after being discharged. That collective ire, fueled by sympathetic lawmakers, will force hospitals to simplify their rate schedules and billing procedures for the benefit of all patients and payers.
Meanwhile, patients with the means to do so should pay their bills. It's the responsible thing to do, and the money will help finance care for people who truly can't afford it. Hospitals have the right to collect that money, in a responsible way, from patients who can afford to pay.