Daily News Updates - Health Insurance News

N.C.’s Underlying Health Care Woes, Pt.4 – Current system unsustainable.

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In many of these cases, the patients without health insurance have tried not to go that route, by staying at home in their illness and not seeking treatment. Often as not, this tends to lead to more serious conditions that are much more costly in terms of expense, health and even life than would be, had they health insurance. Health economist and associate professor, Julianne Treme of UNC Wilmington explains this problem is most prevalent with lower income families (the greatest percentage without health insurance). She tells us that the difference in cost between getting the care these people need and the actual costs exacted by the way we’re doing it now (ER usage and delayed treatment) is quite significant.

An example of how extreme this can be is the treatment for a common cold. Could that patient have health insurance and just visit a doctor’s office, the cost would be around $80. But, because these people don’t have access to health insurance nor this form of medical care, a trip to the ER will cost ‘somebody’ $181 (well over double and paid for by other entities). Not atypical, the New Hanover Regional Medical Center had to report $4 million in losses just last year for treating 22,000 of such cases in the ER. These were, typically, cases where the people who came were not serious enough to be admitted. Of all things, one of the most common of the costly outpatient conditions for the ER was dental disorders. This is not working.

These cases where families have no health insurance and must fall back on the ER’s legal requirement for treatment amounts to around 30% of all visits. There are only a few of these who can pay. The rest are largely un-reimbursed, explains chairman S. Bryan Durham of New Hanover Regional’s ER department. There are cases covered by Medicaid or Medicare, but most of the cost will have to be written off as a loss. Vice president of the hospital’s of business development, John Gizdic, explains: “Last year, we gave away over $100 million in free care.” This is just the loss for one hospital. Nationwide, that figure is closer to $35 billion. Even this figure is not setting still – it is rising quickly.