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Show Ssptal'ills" By GARY R. BLODGETT FARMINGTON - Who should pay for indigent hospital hos-pital costs? THIS IS the complex, and unsolved, question facing the Davis County Commission. The commission was handed hand-ed "bad debt" charges by indigent in-digent patients at the county's two hospitals totaling more than $15,000. One patient's ' billing at Lakeview Hospital was for $7,545. t BILLS FOR six other pa-tients pa-tients at Davis North Medical Center totaled another $7,510. Should taxpayers foot the bill for these uncollectable debts? Or should the hospital tack these debts onto future patients? Someone has got to absorb the debt. DAVIS COUNTY commissioners commis-sioners agreed that the county has "some obligation" to pay indigent costs, if an earnest attempt has been made by the hospital to collect from the r patient. But to what extent should the county be obligated for these expenses? , IN THE past, the commis-j commis-j sion has usually-approved in--digent debts--but not to pay i more than 50 percent of the claim. Thus, the county has been absorbing some of the cost while the medical facility has had to assume the balance of the debt. DEAN HOLMAN, administrator adminis-trator of Davis North Medical Center, and Floyd Morgan, accountant supervisor for the facility, met with the commission com-mission to ask for "additional guidelines and policies by the county for paying indigent costs." "We need to work out some inadequacies and problems that exist with indigent patients," pa-tients," Mr. Holman told the commission. "Our present policies are too vague while neighboring counties have easy-to-understand policies." MR. MORGAN noted that mental indigent patients and those with alcohol problems are supported 100 percent by the county while medical indigent in-digent patients are supported only 50 percent or less. "Fifty percent coverage by the county is not enough," he said. "If the patient is worth getting any county aid at all, he should receive the entire amount." Commissioners Commis-sioners disagreed. COMMISSION Chairman Glen W Flint explained that the county taxes one-fourth mill to raise $75,000 for indigent in-digent costs. "This, doesn't go very far with all the claims for indigent in-digent care that we receive," he said. "Especially when we get one claim for over $7,500 and a few minutes later are presented with six more claims totaling another $7,500." IN REVIEWING the claims, commissioners noted that the large single claim from Lakeview Hospital is for ;' n patient who reportedly suf-, fered injuries when a piano fell on him. He spent 12 days in the Bountiful medical facility. Commissioner Ernest Eberhard noted that "this patient was living in a Salt Lake hotel when the accident occurred. 1 don't know if the accident occurred in Davis County or not." THE CLAIM alleges that, the patient was seriously hurt and was not in condition to be moved to the Veterans Hospital Hospi-tal where free medical treatment treat-ment could have been provided. provid-ed. The claim also notes that the patient is non-employable and does not receive workmen's work-men's compensation. Commissioners also found that two other claims resulted from injuries sustained in a tavern-one when the patient fell off the bar stool and broke his leg, and the other when a patient was shot during a bar room brawl. COMMISSIONERS said they didn't feel responsible to pay these claims. But Mr. Holman explained that everyone-regardless of the nature ot injury or financial finan-cial status of the patient--is treated in the hospital's emergency room. "AFTER THAT, it is determined deter-mined where the patient is to . be hospitalized," he said "But we don't turn anyone away. We provide emergency treatment to everyone." Mr. Holman added that every attempt is made to collect from the patient before a claim is submitted to the county for payment. "IF NECESSARY, we allow some patients to pay monthly," he said. "And we'll exhaust every avenue to find a patient who is trying to avoid payment. We even followed one patient to Oregon and then discovered we couldn't collect because he had no money to pay." The hospital administrator then explained to the commission com-mission that all unpaid debts are absorbed by the hospital which then is forced to increase hospital care rates to cover these losses. "ONE OUT of eight patients need indigent help for medical aid," said Mr. Holman. Hol-man. "Who is responsible for these people? If the debt is not paid, private patients and insurance companies (third parties) have to make up the difference not paid by indigents. in-digents. "It becomes a mora! or philosophical question. We (the hospitals) have to pick up the lost revenue someway or that debt is passed on to future patients." WHO IS an indigent? Commissioners and hospital hospi-tal officials agreed that there are no hard-fast guidelines describing an indigent. MOST HOSPITAL officials take the stand that an indigent in-digent is someone who is physically or mentally unable to be employed, thus is unable to pay hospital costs. Commissioners maintain that the indigent must be a resident of Davis County and that the illness or accident must have occurred in the county. ASKED IF the hospitals would maintain or lower their hospital rates if the county paid 100 percent indigent costs, Mr. Holman answered: "1 can't honestly say that we could because there are so many factors worked into the hospital's rate structure." COMMISSIONER Swapp then responded: "I believe that taxpayers should pay a portion of indigent care-but not all of their bad debts. If I thought bad debts paid by the county now would reduce hospital rates in the future, I'd feel better about it. The commission took the claims under advisement and promised a review of guidelines and policies for future indigent care. |
