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Hospital settlement key step toward equity for patients

Too bad it took courts to get money back to uninsured

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We are at our most vulnerable lying in a hospital bed, and we are more vulnerable still if we are lying there without health insurance.

A class-action settlement returning money to Tenet Healthcare patients charged more than their insured counterparts is an important step toward leveling the playing field for all patients. If hospital charges are based on the cost of doing business, then no one should see a 40 percent cost differential for the same care.

That's the difference attorney A. Camden Lewis claims some patients who paid out of pocket for medical treatment faced compared with what insurance companies had to pay for the same services.

Under a proposed settlement to a class-action lawsuit, Tenet Healthcare, which owns Hilton Head Regional Medical Center, will give refunds to some patients who used the hospital between Oct. 7, 2001, and May 22, 2006. East Cooper Regional Medical Center in Mount Pleasant and Piedmont Medical Center in Rock Hill also could get refunds and discounts.

Judge Kenneth Goode of South Carolina's 6th Judicial Circuit ruled that because hospitals "do not provide for the same discounts for reimbursements, and uninsured patients are not being given those same discounts upon prompt payment of a discounted bill," they're in violation of state law.

The lawsuits, first filed in 2004 and later combined in the class action, claim that the hospitals overcharged uninsured and underinsured patients by not offering discounts like those commonly offered to patients whose medical expenses are covered by insurance companies. The hospitals deny any wrongdoing and say they are settling the case to avoid the time and cost of litigation, according to court documents.

Let's hope the settlement money gets into the hands of the people who paid the bills. Such class action settlements have a way of being so complex to partake in and the overall payback so small that they can seem to be more trouble than they're worth. Tenet and the courts should do all they can to make sure that doesn't happen.

Tenet did the right thing in 2003-2004 when it stopped charging so much more to uninsured and underinsured patients than it did to patients under a negotiated insurance plan.

The company became the first major hospital network to offer formal solutions to uninsured patients when it released its Compact with Uninsured Patients in 2003, according to Elizabeth Lamkin, the island hospital's CEO. The program offers discount rates to all uninsured or underinsured patients who receive treatment in Tenet hospitals, regardless of their income level.

That decision came after a 2002 lawsuit filed in California. Terms of the national settlement are incorporated into the South Carolina agreement.

Lewis said of the South Carolina settlement, "It's the first step to make sure that health care is competitive and also that it's fair. These suits are what protect the people."

We need to find a better way in this country to protect people who lack the resources and the expertise to negotiate with sophisticated health-care companies -- especially at a time when they are least able to do so. It shouldn't take going to court.