Who owns this problems? The latest Wall Street Journal article on excessive hospital charges misses the point

Healthcare Financial Management, Nov, 2004 by Richard L. Clarke

Lucette Lagnado's article "Anatomy of a Hospital Bill," which appeared in the September 21, 2004, issue of The Wall Street Journal, emphasizes the amount of a hospital bill and other charges incurred by an uninsured "middle class" young couple. The article does not focus on the broader based issue of who is responsible for ensuring that health insurance coverage is available and taken. It missed the point of who owns this problem.

In the article, Lagnado emphasizes (as she has done in the past) the size of the hospital bill and the fact that uninsured, non-financially-distressed patients often are charged full prices with little discount.

What is not emphasized in this story is that this couple had the option to obtain affordable health insurance but decided to spend their money on other things, including a BMW ear and European vacation. And after the life saving services were rendered, the couple decided to sue the hospital for "inordinate and inflated rates" for those services.

If the point of the article is that opting out of health coverage carries no risk (and may provide a reward), why would anyone pay for health insurance? Is a decision to decline coverage available from private or public sources simply a lifestyle choice? And who pays for this decision?

This story isn't about hospitals' inordinate or inflated rates; it is about a broken system that cries for repair. Our health policy does not adequately ensure coverage of the uninsured. Focusing solely on hospital charges and encouraging lawsuits by class action lawyers will only make the problem worse.

Defining who owns this problem is critical. Fundamentally, is health insurance simply an option, such as life insurance, or should it be required of everyone, such as auto insurance? Is access to healthcare services a right, such as access to primary and secondary education, or simply a commodity, such as a car or vacation? Defining the answers to these questions is critical for dealing with this problem.

Someone needs to own this problem, and I believe it starts with our health policymakers in Washington, D.C.