High Bills for Covid Tests at a Hospital E.R.

[D J C]

 

The real question raised by “At an Elite Hospital, Huge Bills to Test for Covid” (front page, March 31) is whether the medical delivery system is causing more harm than good.

The U.S. medical industry, designed to fulfill a core social need, has become an uncontrolled behemoth. Aided and abetted by a Congress in thrall to corporate interests, it commandeers enormous amounts of money — about $4 trillion a year. A high percentage of that is waste that could fund social programs that improve health. Our current system drives people to bankruptcy or avoiding health care because of the high cost. In other words, it undermines the very reason for its existence.

We know that many illnesses are a result of inequality, racism, sexism and other social determinants. We can now add to the list of liabilities the medical-industrial complex itself.

 

Over the past year Northwell Health expanded access to Covid-19 diagnostic testing in its emergency departments, including Lenox Health Greenwich Village (the subject of your article), while also making testing available in urgent care centers and doctor’s offices that are far less expensive to operate.

In focusing on the higher billing rates in emergency departments, The Times neglects to explain that payments we receive are based on mandated Medicare/Medicaid rates or payment rates negotiated with commercial insurers. Neither patients nor insurers pay the stated charges typically listed in “explanation of benefits” notices sent to patients by insurance companies, which have generated record profits during this public health crisis.

When patients arrive in an emergency department, federal law requires that they be evaluated and treated, regardless of their ability to pay. Patients requesting a Covid-19 test are advised when they walk in — orally, in a written consent form and with signage at the registration desk — that their test is considered an emergency visit. Regardless of where they are tested for Covid, patients incur no co-payments or out-of-pocket costs.

Fighting this pandemic has required hospitals and health systems to use every tool at their disposal, including offering testing capabilities in many different treatment settings, and setting up a vast network of vaccine distribution sites.

Operational costs incurred by health care providers in running emergency departments far outpace reimbursements they receive from insurers.

 

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