National Nurses United

10 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 0 NEWS BRIEFS NATIONAL W ith the covid-19 pandemic continuing to explode across the country, a new study doc- uments that hospitals jack up charges by as much as 18 times over their costs, a substantial contributor to the grow- ing health care crisis for patients and families. (Read the report, "Fleecing Patients: Hospitals Charge Patients More Than Four Times the Cost of Care, at http://bit.ly/NNU-CCR-Report.) Overall, the 100 most expensive U.S. hos- pitals charge from $1,129 to $1,808 for every $100 of their costs. Nationally, U.S. hospi- tals average $417 for every $100 of their costs, a markup that has more than doubled over the past 20 years. "There is no excuse for these scandalous prices," said Jean Ross, RN, president of National Nurses United, which conducted the study. "These are not markups for luxury condo views, they are for the most basic necessity of your life: your health." It is based on Medicare cost reports for 4,203 hospitals in fiscal year 2018, the most recent data available. Surveys have found that 78 percent of adults have avoided hospital visits and, in 2018, 44 percent skipped medical care due to cost. About 30 percent said they had to choose between paying for medical bills or basic necessities like food or housing. Last year 137.1 million people in the United States reported struggling with medical debt. And if the U.S. Supreme Court throws out the Affordable Care Act, more than 23 million people who currently buy insurance on ACA exchanges or benefit from expanded Medicare would also lose coverage. High hospital charges also drive up Covid- 19 treatment costs. One study found that average charges for a Covid-19 patient requir- ing an inpatient stay can range from $42,486 with no or few complications to $74,310 with major complications. A Commonwealth Fund survey found that 68 percent of respon- dents said that "potential out-of-pocket costs would be very or somewhat important in their decision to seek care if they had symp- toms of the coronavirus." Other study highlights include: • Hospital charges play a major role in mounting health care costs, with health expenditures closing in on one-fifth of the gross domestic product (GDP). The United States far exceeds the rest of the world in per capita costs, though lags behind many other wealthy countries in a variety of health outcomes. • Higher charges generate big profits. Pushed upward by increasing charges, hospi- tal profits have mushroomed by 411 percent since 1999 to a record $88 billion in 2017. • The rise in charges coincides with growing hospital mergers and acquisitions by large systems. The result is increased market consolidation, which leads to higher profits and increased charges, not savings for patients as hospital systems often claim. • Of the 100 hospitals with the highest charges over their costs, for-profit corpora- tions own or operate 95 of them, led by HCA Healthcare, the largest hospital system in the United States, which by itself owns or operates 53 of the top 100. Hospitals sometimes maintain that the charge master price, essentially a list price to bargain over reimbursements from insurers, does not reflect how much insurers actually pay since negotiations between insurers and hospitals are confidential, the report notes. However, a 2017 study found that for Hospitals charge patients up to 18 times cost NNU's report highlights threat to patients amid Covid-19 pandemic surge

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