Insured versus uninsured: The fight for equal pricing in health care

Journal of Legal Medicine

Volumn 29, Issue 4, 2008, Pages 537-552

  Kuntze, Cortney ^a  

^a SOUTHERN ILLINOIS UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONSUMER; HEALTH CARE COST; HEALTH CARE SYSTEM; HEALTH INSURANCE; HOSPITAL BILLING; HOSPITAL POLICY; HUMAN; LAW; REVIEW;

BANKRUPTCY; CONSUMER ADVOCACY; COSTS AND COST ANALYSIS; DELIVERY OF HEALTH CARE; FEDERAL GOVERNMENT; FINANCING, PERSONAL; GOVERNMENT REGULATION; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HOSPITAL CHARGES; HOSPITALS, VOLUNTARY; HUMANS; INSURANCE, HEALTH; MEDICALLY UNINSURED; NATIONAL HEALTH INSURANCE, UNITED STATES; PATIENT CREDIT AND COLLECTION; STATE GOVERNMENT; TAXES; UNITED STATES;

EID: 57149090546     PISSN: 01947648     EISSN: 1521057X     Source Type: Journal    
DOI: 10.1080/01947640802494887     Document Type: Review

References (149)

1. Gina Kolata, Medical Fees Are Often Higher for Patients Without Insurance, N.Y. TIMES, Apr. 2, 2001, at A1.
2. Id.
3. Id.
4. Id.
5. Id.
6. Leah Snyder Batchis, Comment, Can Lawsuits Help the Uninsured Access Affordable Hospital Care: Potential Theories for Uninsured Patient Plaintiffs, 78 TEMP. L. REV. 493, 494 (2005).
7. Gerard F. Anderson, From "Soak the Rich" to "Soak the Poor": Recent Trends in Hospital Pricing, 26 HEALTH AFF. 780 (2007).
8. Batchis, supra note 6, at 494.
9. Id.
10. This commentary only discusses reform in the particular area of hospital pricing. It does not discuss the overall health care system reform at the heart of much controversy in the United States.
11. James McGrath, Overcharging the Uninsured in Hospitals: Shifting a Greater Share of Uncompensated Medical Care to the Federal Government, 26 QUINNIPIAC L. REV. 173, 180 (2007).
12. Anderson, supra note 7.
13. McGrath, supra note 11, at 180.
14. Id. at 178.
15. Reed Abelson & Jonathan Glater, Suits Challenge Hospital Bills of Uninsured, N.Y. TIMES, June 17, 2004, at C1.
16. Kolata, supra note 1.
17. Id.
18. Greg Martin, IRS to Audit "Secret Discounts," SUN HERALD, Dec. 3, 2007.
19. David L. Nie, NonProfit Hospital Billing of Uninsured Patients: Consumer-Based Class Actions Move to State Courts, 4 IND. HEALTH L. REV. 173, 175 (2007).
20. Id.
21. Batchis, supra note 6, at 503.
22. Id.
23. McGrath, supra note 11, at 184.
24. Id.
25. Beverly Cohen, The Controversy Over Hospital Charges to the Uninsured - No Villains, No Heroes, 51 VILL. L. REV. 95, 109 (2006).
26. Batchis, supra note 6, at 504.
27. Associated Press, Uninsured Patients Pay More for Care, MSNBC.com, June 24, 2004, available at http://www.msnbc.msn.com/id/5290172/ (last visited Aug. 27, 2008).
28. Id.
29. Robert Pear, Hospitals Can Provide Discounts to Uninsured and Needy Patients, Bush Administration Says, N.Y. TIMES, Feb. 20, 2004, available at http://query.nytimes.com/gst/fullpage.html?res= 9C0DEFD8103DF933A15751C0A9629C8B63# (last visited Aug. 27, 2008).
30. Anderson, supra note 7, at 780.
31. Id.
32. Id. at 781.
33. Id.
34. See Cohen, supra note 25, at 98-103 (providing a full discussion on the Wall Street Journal articles and their impact).
35. Id.
36. Lucette Lagnado, Twenty Years and Still Paying, WALL ST. J., Mar. 13, 2003, at B1.
37. Id.
38. Lucette Lagando, Twenty Years - And He Isn't Paying Anymore,WALL ST. J., Apr. 1, 2003, at B1.
39. Cohen, supra note 25, at 98-103.
40. Kolata, supra note 1.
41. McGrath, supra note 11, at 190.
42. Id.
43. Batchis, supra note 6, at 499.
44. Id.
45. 60 Minutes: Hospitals: Is the Price Right? (CBS broadcast Mar. 5, 2006), available at http://www.cbsnews.com/stories/2006/03/02/60minutes/ main1362808.shtml (last visited Aug. 27, 2008).
46. Id.
47. Id.
48. Id.
49. Id.
50. Id.
51. Batchis, supra note 6, at 506.
52. Bureau of Nat'l Aff., Multidistrict Judicial Panel Rejects Motion to Consolidate, Transfer Charity Care Cases, 13 HEALTH L. REP. 1533 (2004).
53. Jack Burns, Are NonProfit Hospitals Really Charitable?: Taking the Question to the State and Local Level, 29 J. CORP. L. 665, 667 (2004).
54. 26 U.S.C. § 501(c)3 (2000). (pertaining to "corporations, and any community chest, fund, or foundation, organized and operated exclusively for religious, charitable, scientific, testing for public safety, literary, or educational purposes, or to foster national or international amateur sports competition (but only if no part of its activities involve the provision of athletic facilities or equipment), or for the prevention of cruelty to children or animals, no part of the net earnings of which inures to the benefit of any private shareholder or individual, no substantial part of the activities of which is carrying on propaganda, or otherwise attempting, to influence legislation (except as otherwise provided in subsection (h)), and which does not participate in, or intervene in (including the publishing or distributing of statements), any political campaign on behalf of (or in opposition to) any candidate for public office").
55. Nie, supra note 19, at 180.
56. Id.
57. Id.
58. Id.
59. Id.
60. Id.
61. Cohen, supra note 25.
62. Lisa W. Clark et al., What May Arrive in Tomorrow's Mail?: An Analysis of Class Action Lawsuits Concerning Hospital Billing of Uninsured Patients, 13 BNA HEALTH L. REP. 1134 (July 29, 2004).
63. Cohen, supra note 25, at 128-30.
64. Utah County v. Intermountain Healthcare, Inc., 709 P.2d 265 (1985).
65. Id.
66. Id. at 279.
67. Id. at 278.
68. Burns, supra note 53, at 674-76 (discussing how state courts have handled tax-exemption claims).
69. Neville M. Bilimoria, Patients Challenge NonProfit Hospitals' Charitable-Care Practices, 93 ILL. B.J. 134 (2005).
70. Id.
71. Id.
72. Id.
73. Steve Stanek, Hospital Loses Tax Exemption in Landmark Ruling, BUDGET & TAX NEWS, Dec. 1, 2006, available at http://www.heartland.org/Article.cfm?artId=20222 (last visited Aug. 27, 2008).
74. Bilimoria, supra note 69.
75. Clark, supra note 62.
76. Id.
77. Id.
78. Id.
79. Urquhart v. Manatee Mem. Hosp., 2007 WL 2010761 (M.D. Fla).
80. Id.
81. Id.
82. Morrell v. Wellstar Health System, Inc., 633 S.E.2d 68, 71 (Ga. App. 2006).
83. Id.
84. Id.
85. Huntington Hosp. v. Abrandt, No. 24121, slip op. at 3 (Sup. Ct. N.Y. Apr. 9, 2004).
86. Id.
87. Id. (citing Flushing Hosp. & Med. Ctr. v. Woytisek, 41 N.Y.2d 1081, 1082-83 (1977)).
88. Heartland Systems v. Chamberlin, 871 S.W.2d 8 (Mo. Ct. App. 1993); see also Batchis, supra note 6, at 526-27.
89. Id.
90. Id.
91. These laws are usually called the Unfair and Deceptive Acts and Practices (UDAP) statutes.
92. Clark, supra note 62.
93. Morrell, 633 S.E.2d at 71.
94. Id.
95. Id.
96. Nygaard v. Sioux Valley Hosp. & Health Sys., 731 N.W.2d 184 (S.D. 2007).
97. Id.
98. Id.
99. Id.; see also Associated Press, Court Upholds Dismissal of Lawsuits on Hospital Pricing, SIOUX CITY J., Apr. 6, 2007, available at http://www.siouxcityjournal.com/articles/2007/04/06/ news/south_ dakota/d1b6e3c1318e0409862572b5000cda57.txt (last visited Aug. 27, 2008).
100. Id.
101. Id.
102. Servedio v. Our Lady of the Resurrection Med. Cen., No. 04L3381, 2005 WL 5176757 (Ill. Cir. Ct. Mar. 9, 2005).
103. Id.
104. Id.
105. Id.
106. Id.
107. Id.
108. Id.
109. Id.
110. Id.
111. Bureau of Nat'l Aff., Settlement of Uninsured Lawsuit in Illinois Against Resurrection Health Care Confirmed, 9 HEALTH CARE FRAUD REP., No. 12 (June 8, 2005) available at http://pubs.bna.com/ip/BNA/hfr.nsf/is/a0b0x3x3q3 (last visited Aug. 27, 2008).
112. Id.
113. Id; see also Nie, supra note 19.
114. Settlement of Uninsured Lawsuit, supra note 111.
115. Nie, supra note 19.
116. Id.
117. Id.
118. Id.
119. Sutter Health, Sutter Health Settles Lawsuit Over Prices Charged to Uninsured; Reaffirms Its Charity Care and Discount Policies, available at http://www.sutterhealth.org/about/news/news06_settlement.html (last visited Aug. 27, 2008).
120. Id.
121. In re Tenet Healthcare Cases II, 2005 WL 1949562 (Cal. Sup. Ct. 2005).
122. Cohen, supra note 25, at 144.
123. Sutter Health, supra note 119.
124. Chris Rauber, CHW Agrees to Settle Suit Over Uninsured Pricing, SAN FRANCISCO BUS. TIMES, June 14, 2006, available at http://www.bizjournals.com/sanfrancisco/stories/2006/06/12/ daily35.html?f=et78&hbx=e_du (last visited Aug. 27, 2008).
125. Id.
126. Id.
127. Catholic Healthcare West Class Action Settlement Information Web site, available at http://www.chwsettlement.com/ (last visited Aug. 27, 2008).
128. Victoria Colliver, Settlement Reached in Sutter Lawsuit: Hospital Group Will Give Refunds, Discounts to Former Patients, SAN. FRAN. CHRON., Aug. 4, 2006, at C1.
129. Reed Abelson & Jonathan Glater, Suits Challenge Hospital Bills of Uninsured, N.Y. TIMES, June 17, 2004, at C1.
130. Nygaard, 731 N.W.2d at 184.
131. Cohen, supra note 25, at 141.
132. Id.
133. Id.
134. Ibid
135. Id.
136. Batchis, supra note 6, at 494.
137. Id.
138. McGrath, supra note 11, at 189.
139. Id.
140. CAL. HEALTH & SAFETY CODE §§ 127400-127446 (West 2007).
141. Id.
142. N.Y. PUB. HEALTH § 2807-k (McKinney 2007).
143. Id.
144. Julie Appleby, Hospitals Sock Uninsured with Much Bigger Bills, USA TODAY, available at http://www.usatoday.com/news/health/ 2004-07-19-lawsuits_x.htm (last visited Aug. 27, 2008).
145. Sara Hoffman Jurand, Major Hospitals Agree to Stop Overbilling Uninsured Patients, 41 TRIAL 80 (Nov. 2005).
146. WCCO.Com, Hospitals Extend Plan for Discounts to Uninsured, Apr. 4, 2007, available at http://wcco.com/politics/hospitals.discounts. uninsured.2.366363.html (last visited Aug. 27, 2008).
147. Id.
148. Id.
149. Servedio, 2005 WL 5176757.