Our Health Care System Is Stupid (Gwen Moritz Editor’s Note)

Our older son, who works freelance jobs backstage in Chicago’s vibrant theater industry, turned 26 last week. And you know what that means: At the end of the month, he’ll no longer be eligible for the health insurance that covers the rest of the family.

He’s been shopping for health insurance on the exchange, weighing his tax credits and trying to anticipate what April 15, 2017, will look like.

“This is stupid,” he wrote in an unusually well-constructed text message. “Life is stupid. Adulting is stupid. Can’t I live in a country where figuring out my taxes and figuring out my health insurance are the same thing? No? Stupid.”

It’s no wonder Bernie Sanders’ promise of “Medicare for all” held such an appeal for millennials, many of whom enter adulthood without the advantages that have allowed my son to follow his professional dream, like debt-free college degrees and parents who can afford to carry him on their insurance for a few years.

For my particular kid, Obamacare has been a good thing, allowing him to start his career without a big health insurance bill and then to get his own affordable coverage. But there are still so many problems with the health care industry in our country that every week seems to bring fresh outrage.

Last week, for instance, our Senior Editor Mark Friedman described the proliferation of class-action cases filed against hospitals that hound accident victims for payment while refusing to bill the insurance companies that would pay. It’s about getting more money out of any settlement that the victims ultimately receive, of course.

Baptist Health, with its network of hospitals across the state, started averaging an additional $600,000 in revenue every month when it adopted the policy of bypassing the accident victim’s insurance and holding out for third-party payment. At least that’s what its consultant, RevClaims of Jackson, Tennessee, bragged on its website. The additional revenue was presumably enough to make it worth paying RevClaims $2.1 million in 2014, as Baptist Health reported to the IRS.

Baptist and the other hospitals insist they are doing nothing wrong by seeking out the highest payment, and they may be right. But reading the stories of the patients who have been subjected to medical liens and collection calls is crazy-making. It’s easy to imagine being the hapless accident victim who has been paying health insurance premiums all along but can’t get the hospital to accept payment and stop the collection calls.

“With the exception of almost all reporting about Donald Trump, I can’t remember when I’ve been as miffed,” a CPA told me in an e-mail. “The hospital pursuing the victim through collection agencies, when they have deliberately not filed the patient’s insurance claim as they should is clearly a case of the victim being further victimized.”

In addition to the sympathy factor, this story is also an aggravating reminder that medical bills are fiction anyway. If an insurance company can get the services for $20,000, why should anyone — even the person who caused the injury — be billed $60,000? My son would say that’s stupid, and I wouldn’t be able to disagree.

A few days after Friedman’s story appeared, the Arkansas Democrat-Gazette treated us to trial testimony from a civil case that the state attorney general’s office brought against a “procurer” of new patients for chiropractors. (Friedman did excellent reporting on this slimy phenomenon years before former AG Dustin McDaniel filed suit in 2014.)

“A Maumelle man accused of using misleading tactics to recruit patients for his chiropractor clients was paid $91,000 in one month by a Little Rock clinic in 2013, according to evidence presented in Pulaski County Circuit Court on Wednesday,” D-G reporter John Lynch wrote.

It seems a Little Rock chiropractor named Heath Delane Lenox was paying Roger Pleasant $600 for each client he recruited to Lenox’s Markham Injury Center. To earn $91,000, Pleasant had to round up 150 new clients, and all of them had to be insured and undergo at least three billable treatment sessions. That’s in a single month, from one sole proprietor.

I’ve never used a chiropractor, but if I did, I’d be livid if I learned that my doctor padded his bills sufficiently to pay hundreds of thousands of dollars a year to someone who was then accused of deceiving other clients. That’s not stupid. That’s obscene.

Gwen Moritz is editor of Arkansas Business. Email her at GMoritz@ABPG.com.