Stupid healthcare fix of the week

Today's lead story in the Boston Globe (Romney aide targets debt at hospitals; Aggressive collecting from patients urged) reports that a top aide to Governor Mitt Romney thinks the answer to the health care financing crisis is for hospitals to be tougher in collecting from the uninsured.

"Hospitals... are on the passive side" in terms of collection, Murphy said in an interview with the Globe. He said hospitals need to demand more payment upfront and use all legal options to collect from "recalcitrants."

The Globe story rightly points out that the nationwide trend is to encourage hospitals to "restrain" their collection efforts rather than getting tougher. What Romney's policy director, Tim Murphy doesn't seem to understand is that hospital bills are different from other types of bills:

• The customer has no idea of the cost upfront and can't choose what services are provided
• The bills are often unintelligible and/or wrong
• Those least able to pay (the uninsured) are charged higher prices than those who are most able
• Being in the hospital and recuperating at home afterwards are often associated with financial stress for patients. Out-of-pocket costs rise and income falls. Even people who start out with a job, savings, and insurance can end up in bankruptcy

He also doesn't realize that hospitals are already quite aggressive in their collections efforts. They send endless bills and refer cases to collection agencies.