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The state’s hospitals are grappling with a rising number of uninsured patients, and unpaid medical bills are forcing many administrators to cut staff and inventories to make up the difference.
For years, the percentage of Minnesotans without health insurance has been the lowest in the country. But the state slipped to No. 2 behind Massachusetts last year with an uninsured rate of 7.4 percent, the highest level in Minnesota in eight years.
“Now we’re seeing our first increase (in the uninsured) in years. So we know we are in trouble,” said Kathleen Call, an associate professor of health policy and management at the University of Minnesota School of Public Health.
Minnesota hospitals exist as not-for-profit entities, meaning they treat people who cannot afford to pay. Those charity-care policies usually force the hospitals to foot most of the bill, which as most know can get real expensive in a hurry.
Take the case of 46-year-old dishwasher Barry Ghearing. He arrived at Hennepin County Medical Center in Minneapolis last year after missing most of the early warning signs for throat cancer. By the time he received treatment, the disease had advanced to Stage 3.
“He was near death when he came in here,” said Dr. Richard Zera, chief of surgical oncology at HCMC. “He had pneumonia, an infection around his lung. We had to drain the lung. He was on a ventilator. And in the process of evaluating him, we found cancer in his throat.”
And until the state stepped in recently, Ghearing was uninsured.
The reasons for the rise in uninsured are many. State programs like MinnesotaCare have reduced the number eligible by raising qualifying income levels. Some businesses have dropped health care coverage as insurance premiums have skyrocketed. Others reduced benefits or make their employees pay for a bigger share.
So more and more workers are opting out, unable or unwilling to pay the hefty premiums. Without insurance, people are less likely to see a doctor, which means they usually arrive at the hospital even sicker, Call said.
He eventually was diagnosed with throat cancer and enrolled in the state’s Medical Assistance program.
In two hospital stays last year, Ghearing racked up a bill of $276,000. Medical Assistance reimbursed the hospital a total of $96,000 and HCMC was stuck with the rest.
Last year, the hospital spent $15million to 20 million on patients who qualified for public programs and even more on patients who did not qualify because they did not meet age or income requirements.
According to the Minnesota Health Department, total uncompensated care in Minnesota reached $191.2 million in 2005, up by 26 percent from 2004.
In 2005, Minnesota hospitals spent $80.3 million on charity care and wrote off almost $111 million more while paying for bills that went unpaid by the patient.
Because it is publicly owned, HCMC doesn’t have the option of turning patients away.
“I don’t have to ask them if they have insurance,” Zera said. “I take care of them. I’m proud of my mission, but sometimes it just breaks your heart. I wish I could say this is an uncommon occurrence, but I can’t.”
Last year, uncompensated care — charity care and bad debt — at Regions Hospital in St. Paul was up 28 percent to $41.4 million. At St. Mary’s Medical Center in Duluth, uncompensated care rose
38 percent over two years to $6.5 million.
“It’s a significant chunk
of our operating expenses,” said Lynn Abrahamsen, HCMC’s chief executive. “Hopefully, public policy
will catch up with reality. We may be close to a tipping point.”
