North Carolina’s seven large hospital systems reaped billions in cash and financial investments after receiving taxpayer-funded Covid relief money, state Treasurer Dale R. Folwell noted. At the same time, "one in five families is in medical debt collection" due to monopolistic practices, he charged.
In a Sept. 8 press release, Folwell's office stated that the hospitals "recorded $5.2 billion in net profits in 2021, when six hospital systems made higher net profits than in the years before the pandemic."
That included:
• Duke Health scored a 41% net profit margin of $1.8 billion in 2021. Its net profit margin was 11% in 2019.
• Atrium Health took the most taxpayer relief dollars, collecting $589 million in Covid relief and another $438 million in Medicare advance payments.
• Atrium Health made a $1.7 billion net profit after its merger with Wake Forest Baptist Health in 2021.
• The dominant hospital systems did not share their profits with disadvantaged patients. Charity care spending fell across a third of 104 hospitals in 2020.
• Some hospitals increased their billing of poor patients eligible for charity care, while Atrium Health sued hundreds of patients.
Since the pandemic hit, North Carolina has become one of the "most unaffordable and monopolistic states" in the nation for health care, Folwell said.
"Medical debt is crippling North Carolinians. One in five families is in medical debt collection. Workers lose 20% of their paycheck to health care costs on average. Nearly 40% of Americans reported cutting back on food, utilities, or gas to pay health care bills. Health care costs drove almost half of adults to report delaying or skipping necessary medical care," Folwell said, adding “the stories we hear are heartbreaking. Everyone knows that something is wrong, especially in Western North Carolina."
Folwell noted that "many hospitals in North Carolina have failed to equal their tax exemption with charity care spending," which helps the underinsured and uninsured. "Instead, some hospitals billed $149 million to poor patients – or encouraged patients to open 'medical credit cards' that can charge up to 18% interest on medical debt. Hospitals have even sued more than 1,000 patients for medical debt, including during the pandemic."
Brevard Mayor Maureen Copelof, who has initiated a new lawsuit against HCA for the City of Brevard, noted that hospitals are asking people to pay their entire annual deductible up front before getting medical help. Many people don’t ever reach their whole deductible. Hospitals are also charging for services that were never done and billing patients directly and threatening collections without submitting bills to insurance or Medicare/Medicaid, the mayor added.
“Healthcare is one of the most critical things that every elected official needs to get involved with,” said Copelof. “Your stories are heartbreaking. I listen to them, and I say, 'How in God’s name did we get to where we are right now?' It’s unbelievable.”
The North Carolina Retired Governmental Employees’ Association website states that 80% of medical bills contain errors. They state as example how knee replacement costs can vary from less than $30,000 to more than $80,000, depending on where you go, but patients can’t find that information easily, “because most hospitals still haven’t fully complied with federal price transparency rules, hiding prices from patients…Worse, nothing protects family members from debt collectors. Both hospitals and nursing homes can pursue spouses and children for unpaid medical bills in North Carolina.”
Nearly 50 North Carolina state assembly members are co-sponsors of House Bill 1039. The Medical Debt De-Weaponization Act would vault North Carolina to second place in the nation for protections against medical debt, the lawmakers say.
“People shouldn’t be fearful about getting medical attention in this state because of their fear of a medical bill or having their credit rating weaponized,” Folwell said.
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