I’m letting a pretty big secret out of the bag by sharing with you that there is no such thing as uncompensated care. You’re going to hear a lot about uncompensated care over the next few months as the discussion surrounding Medicaid expansion begins to gain more traction.
Many people will try to focus the debate on uncompensated care but that is a little misleading. The truth is there is no such thing as uncompensated care. There are only unpaid bills that get picked up by somebody else. The Affordable Care Act expands Medicaid coverage to cover people earning up to 138% of the federal poverty level and states must choose if they want to participate in the expansion.
Those who will be newly eligible for coverage are working people who do not have access to affordable insurance through their job and can not afford to buy coverage in the open marketplace. This is where the myth of uncompensated care comes into play. The consequences for not participating in Medicaid expansion contributes to this myth.
There are consequences for all of us when a few of us do not have some kind of health coverage. The uninsured avoid routine care which means they do not have access to cost-effective preventive care that would keep them away from hospital emergency rooms. Frequently, when those without coverage do seek care they are often sicker than they would have been had they been under the care of a primary care physician and in many instances they make the emergency room their first stop when they need routine care.
So think about this for a moment; those without coverage are sicker than need be when seeking care and they seek care in a very expensive setting. The result – very high and often unpaid bills which causes hospitals to raise prices for all paying customers to pay for the uncompensated care.
So now you know the myth of uncompensated care. There is no such thing as uncompensated care, there are only unpaid bills that get picked up by someone else. If it’s all still confusing think about this the next time you eat at a restaurant. When the waitress delivers your bill ask her for the bill from the three closest tables as well. The people at the other tables eat free and you’re stuck paying for food you never ate.