Poll: North Carolinians want hospitals to drop lawsuits against patients, improve charity care

jneff@newsobserver.com May 15, 2012 

North Carolinians overwhelmingly favor banning hospitals from placing liens on the homes of patients who don’t pay their bills, according to a new poll.

The large majority of voters also think hospitals should be required to disclose their charity-care policies, according to the poll commissioned by N.C. Policy Watch, a liberal watchdog group.

The two hospital questions on the poll were prompted by a recent investigation by The (Raleigh) News & Observer and the Charlotte Observer, which found North Carolina hospitals have filed more than 40,000 bill-collection lawsuits in the five years ending in 2010.

Hospitals win most suits and put liens on the homes of patients. Those liens can make it impossible for patients to sell or refinance their homes.

The stories also found that more than one-third of the hospitals – including Sampson Regional Medical Center and Vidant Duplin Hospital – didn’t provide details about their charity-care policies on their websites.

In the poll of 600 voters, conducted May 11 through May 13 by Public Policy Polling, 77 percent of respondents said hospitals should not be allowed to place liens on the homes of people who are unable to pay their bills. Fourteen percent said they hospitals should be allowed to, and 9 percent said they weren’t sure.

Seventy-one percent of Republican respondents said liens shouldn’t be allowed, compared to 85 percent of Democrats. Respondents tended to disapprove of liens regardless of their sex, race and where they live.

“(North Carolinians) don’t think hospitals should be treating this like credit-card debt,” said Rob Schofield, policy director for N.C. Policy Watch. “This isn’t like a big-screen TV purchase or buying sports tickets. They understand families shouldn’t be losing their homes because someone got sick through no fault of their own.”

Most of the N.C. lawsuits – more than 24,000 over the five-year period – were filed by two entities: Carolinas HealthCare System, a multibillion-dollar nonprofit hospital chain based in Charlotte, and Wilkes Regional Medical Center, a single hospital in North Wilkesboro that is managed by Carolinas HealthCare.

Charity care often not noted

In North Carolina, hospital charity care policies aren’t always well advertised. About two thirds of the more than 30 uninsured patients interviewed by the newspapers said they were never informed about charity care when they sought treatment at North Carolina hospitals. And during visits to emergency rooms, an Observer reporter found no information about the hospitals’ charity-care policies.

Eighty-one percent of poll respondents said hospitals should be required to inform all patients of their policies for free and reduced-price care. Twelve percent said they should not, and 7 percent said they weren’t sure.

Members of both major political parties support disclosure: Eighty-six percent of Democrats and 75 percent of Republicans.

Gov. Bev Perdue will introduce a proposal this week that would require hospitals to make the details of charity-care programs more readily available to patients, a spokesman said.

The plan would require hospitals to publicly post the hospital’s financial-assistance policy – and to print those policies on the bills they send to patients.

Perdue also has proposed making hospital prices and bills more transparent. In her budget bill, Perdue asked the legislature to allocate $100,000 to the N.C. Institute of Medicine to come up with recommendations to help patients better understand hospital prices and bills.

Some lawmakers – including state House Speaker Thom Tillis and Senate President Pro Tem Phil Berger, both Republicans – say patients need an easier way to find key information about hospital pricing and charity care. Tillis said lawmakers will likely work with the hospital industry to make more data available.

Mark Johnson, Perdue’s spokesman, said the newspaper series reinforced the governor’s concerns about the lack of transparency in health care pricing. Before she ran for the state House in 1986, Perdue was a gerontologist at Craven Memorial Hospital in New Bern.

“As the governor has traveled the state and talked with North Carolinians, she has heard many concerns and complaints about health-care billing and how difficult it is to understand – complaints similar to those you have heard and included in your stories,” Johnson said.

Transparency in billings

Pam Silberman, president of the Institute of Medicine, said she only learned of the governor’s proposal Thursday when the budget was announced. “All I know is what I’ve read,” she said.

Silberman said the concept of transparency in health care is “not unique to hospitals” and that her group has studied health-reform ideas directed at “making consumers more informed about a whole host of things.”

The Institute of Medicine was established by the General Assembly to provide nonpartisan information and research on health issues. Its board members include doctors, nurses and leading executives from the hospital and insurance industry.

A third question on the poll asked respondents their opinion about provisions in the federal health care reform law that would ban insurance companies from denying coverage to children with pre-existing conditions and allow parents to enroll children in their family coverage until they reach age 26.

Asked whether those provisions should be repealed, 65 percent said no, 24 percent said yes and 11 percent said they weren’t sure.

Spokesmen for the N.C. Hospital Association did not return phone calls or emails requesting comment on the poll.

Neff: 919-829-4516

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