Stories illustrate hidden health care costs and benefits

If you have experienced sticker shock at the gas pump or new car dealership lately, try opening your medical bill.

But a couple of news stories this week shed new light on the cost of health care.

One, about a program to help pay for those who repeatedly and routinely use emergency rooms, shows one place where the money goes.

Another reinforces the message, revealing the massive amount of health care and other benefits Nebraska hospitals provide without receiving any pay.

According to the Lincoln Journal Star, over a 12-month period, 35 patients, who have since enrolled in the free Lincoln ED Connections program, made a combined total of 377 visits to Lincoln emergency departments. Twelve who made the most visits received $231,869 in unreimbursed care for that time period.

Under the new program, started in October and funded by --a $300,000 local grant, the visits by those frequent patients has been reduced by about two thirds.

By joining forces to share records, space for staff and other resources, three Lincoln hospitals confronted the problem and made improvements. For instance, one woman who had appeared at emergency departments 13 times in three months was found to be unable to read and was taking too many medications.

While the hospitals declined to release just how much money is being saved, they are keeping track of it and expect the savings to taxpayers and hospitals to be substantial.

And, Lincoln's emergency rooms are only a microcosm of the entire picture. According to the Nebraska Hospital Association, in 2004, Nebraska hospitals provided nearly $633 million in unpaid community benefits.

That includes traditional charity care, unpaid costs of public programs, non-billed community services, research, medical education, subsidized health services, cash and in-kind donations, and $127.6 million in bad debt.

All of which have to be allowed for in properly balanced hospital budgets.

"These figures illustrate that Nebraska hospitals are committed to caring and providing health care services to everyone who enters their doors, 24 hours a day, seven days a week," according to Molly C. Nance of the NHA. "Nebraska hospitals serve not only as high quality health care providers, but also as substantial economic drivers in their communities. Hospitals are frequently among the largest employers in their communities and help support a variety of affiliate businesses," she said.

Is quality health care expensive? Yes.

But next time you experience sticker shock of the medical kind, remember the rest of the story.