In the unending debate about the nation's uninsured and indigent
population, the issue of charity care is often a footnote. Yet, discussion
of it is integral to any healthcare solution regarding the
uninsured. Hospital charity care is uniquely American; a safety net that is
often unnecessary in nations with universal health coverage.
The availability of charity care at US hospitals actually serves to mask
the scope of our uninsured problem. Yet, these acts of charity are all that
stand between a thorny policy dilemma and an access crisis for millions of
Americans. Inconsistencies in the way charity care is delivered, reported
and paid for have made it a confusing and difficult topic. However, these
details have never been more important in today's health system because
charity care affects healthcare resources, bed capacity and physician
time. Charity care costs are reallocated to other patients and failure to
understand the costs muddies the issue for all.
The overwhelming majority of charity care is provided by not-for-profit and
governmental hospitals. The debate around charity care is heightened by the
renewed and critical focus on the covenant between a hospital's
not-for-profit tax status and the ensuing benefit to the community. Behind
the court cases, congressional hearings, and newspaper stories on this
issue is a complicated story that cannot be explained in simple sound
bites.
Papers:
