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Toni Talks about PT Today

The Cost of Rehab

Published November 8, 2011 3:19 PM by Toni Patt

I recently learned that my facility isn't as generous as I first thought. I've previously said we will admit patients to our rehab unit with or without insurance. I knew those patients were sent bills for their stays. A few days ago, I learned those bills are sent to collection agencies. Some of our uninsured patients have lost houses as a result.

I guess I should have seen that coming. Obviously the hospital would want the bill to be paid. If the bill wasn't paid, some action would be taken. If you follow that line of thought, it is reasonable that a collection agency or other entity of that nature could be consulted. For many uninsured patients, the house is their only asset. Once it is gone they have nothing.

I wonder if they think therapy was worth the price of a house. I wonder if they would make the same decision if they knew the tradeoff was the house. I would certainly have to think about that. Generally, rehab doesn't put patients back the way they were. Instead it gets them back to functioning. Some people will never return to their prior functional level no matter how much therapy they receive.

Is that worth the price of a house? Everyone knows that patients must be given a choice. Usually we think of that choice in terms of which facility or what level of care. For the uninsured there is a different choice to be made. Do you want therapy if you have to pay for it later?


Good post, Toni.  Certainly makes you think.  

In the case where you are sick enough to need medical care to the extent that your bill could cost you your house, are you or your immediate family members even in the frame of mind to consider the loss of your home being a realistic outcome?  I doubt it.  To that extent, is it really a "choice"?  It is a consequence, but not necessarily a choice that was made.  

This takes me back to Dean's post about undocumented foreigners, specifically the Chinese man and his family.  Why did the hospital not go after them?  Why do they still get to keep their house while your American patients lose theirs?

No doubt, our American system needs work.

Janey Goude November 8, 2011 9:52 PM

One of the arguments I have made for a single payer insurance plan and/or national health insurance is this very situation you describe. The NHS in the UK is not perfect, far from it, however nobody here ever lost their home because of unpaid medical bills.

There are some who will say that is the patient's choice and therefore their responsibility when things go wrong. That view doesn't take into account that some people don't have insurance, not by choice, but through loss of job. It also doesn't take into account that some people loose their employment and insurance once they become ill. It becomes a downward spiral with the end result being impoverished people who aren't well enough to work to pay back the hospital.

The NHS needs work, but not nearly as much as the US system.

Dean Metz November 8, 2011 4:11 PM

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