Human Rights Watch, the nonprofit that has for decades drawn attention to victims of war, famine and political repression around the world, is targeting US hospitals for pushing millions of American patients into debt.
In a new report published June 15, the group calls for stronger government action to protect Americans from aggressive billing and debt collection by nonprofit hospitals, which Human Rights Watch said systematically violate patients’ human rights. doing less than
“Given the high prevalence of hospital-related medical debt in the US, this system is clearly not working,” concludes the report, which builds on an ongoing investigation into medical debt by KFF Health News and NPR. is on the scale.
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The report continues: “The US model of subsidizing privately operated hospitals with tax exemptions in the hope that they will increase access to hospital care for non- and underinsured patients is fueled by abusive medical billing and debt collection practices.” and undermines human rights, including the right to health.”
Nationwide, nearly 100 million people — or 41% of adults — have some form of health care debt, found a KFF survey conducted for the KFF Health News-NPR project. And while patient debt is being driven by a range of medical and dental bills, polls and studies show that hospitals are a major contributor.
KFF polling found that nearly a third of American adults with healthcare debt owed money for a hospitalization. Half of them owe at least $5,000. Nearly a quarter owe $10,000 or more.
The scale of this crisis — which is unique among wealthy countries — prompted Human Rights Watch to issue the new report, said researcher Matt McConnell, its author. “Historically, Human Rights Watch has been an organization that has focused on international human rights issues,” he said. “But on medical debt, America is a real outlier. What you’re seeing is a system that privileges some but creates huge barriers for people accessing basic health rights.”
Hospital industry executives defend their work, citing the extensive work hospitals do to help the communities they serve. “As a sector, hospitals provide more benefits to their communities than any other sector in healthcare,” Melinda Hatton, general counsel for the American Hospital Association, wrote in response to the Human Rights Watch report.
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Federal law requires private, tax-exempt hospitals — which make up more than half the nation’s medical centers — to provide care to low-income patients at no cost or at a discount. But reports from KFF Health News and others have found that many hospitals make it difficult for patients to obtain this assistance.
At the same time, thousands of medical centers – including many tax-exempt ones – engage in aggressive debt collection tactics to pursue patients, including garnishing patients’ wages, placing liens on their homes, or using third-party debt collectors. involves selling its debt to
Overall, KFF Health News found that about 5,100 hospitals in the country that serve the general public have policies calling for legal action or using other coercive tactics against patients. And 1 in 5 would deny non-emergency care to people with outstanding debt.
“Medical debt is drowning many low-income and working families, while hospitals are taking advantage of the nonprofit tax status as they pursue families for medical debt,” said Marceline White, executive director of Economic Action Maryland. ” Advocacy group has helped create stricter rules to ensure Maryland hospitals can more easily access financial aid and prohibit hospitals from some aggressive debt collection tactics, such as placing liens on patients’ homes .
Similar efforts are underway in other states, including Colorado, New Mexico, New York, Oregon and Washington. But many patient and consumer advocates say stronger federal action is needed to expand patient protections.
The Human Rights Watch report — titled “In sheep’s clothing: United States’ poorly regulated nonprofit hospitals undermine health care access” — lists more than a dozen recommendations. This includes:
- Congress should pass legislation to ensure that hospitals provide at least as much charity care as they receive in public subsidies.
- The IRS should set uniform national standards on patients’ eligibility for financial assistance across nonprofit hospitals. Currently, hospitals are free to set their own standards, resulting in wide variation, which can confuse patients.
- The Consumer Financial Protection Bureau, a federal watchdog agency, should crack down on loan sharks who don’t ensure patients are screened for financial assistance before pursuing them.
- The federal Centers for Medicare and Medicaid Services, which administers the two massive public insurance programs, should penalize hospitals that do not provide adequate financial assistance to patients.
“Nonprofit hospitals are contributing to medical debt and engaging in abusive billing and debt collection practices,” McConnell said. “This is due to the absence of clear guidelines and inadequate federal government enforcement of existing regulations.”
KFF Health News is a national health policy news service. This is Henry J. is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.