Emergency Rooms Charge Uninsured Upfront to Deter Non-Emergency Care

We might be seeing the start of a shift in the emergency-room-care paradigm.

For many uninsured, the emergency room was the defacto and almost cost-free way to get something like a nagging cough or an upset stomach attended to. You could be seen, treated, and then have the “I’m not insured” conversation.

Then there’s the Nashville-based HCA, the nation’s largest for-profit hospital chain. They’ve implemented a $150 upfront fee for non-urgent care at the emergency.

“It has been a successful part of helping to reduce crowding in emergency rooms and to encourage appropriate use of scarce resources,” HCA spokesman Ed Fishbough said.

Which: sure. Okay. And I see what you did there, Ed Fishbough. But the other thing that it’s done is begin to improve hospital profitability. Fewer free-care cases on the books means more black-than-red ink.

The article, linked above, does a fairly good job of showing both sides of the argument: Charging upfront helps hospitals’ bottom lines and does something about the “bad debt” budget item; charging, though, could also deter the uninsured from medical help.