NCPA - National Center for Policy Analysis

Uninsured Often Pay Higher Medical Fees

April 2, 2001

Americans without health insurance pay more for health care, experts report. That's because health insurance companies insist on hefty discounts for their covered clients -- while physicians must charge their uninsured patients more to make up for the cash-flow loss.

  • For example, a New York gynecologist says he gets $25 for a routine examination of a woman insured by group health insurance, and charges $175 for the same exam of a woman without insurance.
  • In a medical emergency, uninsured people can get care -- even if they walk away from their bills.
  • But if it is not an emergency, doctors and hospitals may require payment or a deposit in advance from those without insurance.
  • Hospital administrators report experiencing the same situation, which began about a decade ago when insurers offered to make certain hospitals "preferred providers" -- sending increased volumes of business their way in exchange for lower fees.

Doctors and hospitals feel they are in the middle of a financial and ethical predicament. They shudder when they must charge poor and uninsured patients more for treatment than they charge the insured. But they don't want the reputation of being the place to go if a patient is uninsured and can't pay much.

Some insurers are experimenting with medical discount cards. They ask individual health-care provider networks to give discounts to groups of uninsured persons who will pay their own bills. Anyone can get the cards and pay by the month.

Source: Gina Kolata, "Medical Fees Are Often More for Uninsured," and "Medical Discount Cards Attract the Uninsured," New York Times, April 2, 2001.


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