The Price We Pay: What Broke American Health Care--and How to Fix It

by Marty Makary

I told him that Dina didn’t have a contractual obligation to pay, which she didn’t, because she had struck out the clause saying she’d pay whatever they charged. I added that the law prohibited collections agencies from hurting her credit if they did not have a contract for services. The hospital director then made a big show of offering Dina financial aid. But mind you, this wasn’t an act of generosity. The Affordable Care Act requires hospitals to have financial assistance policies, and sets parameters for what a hospital can do. The rules say hospitals are not allowed to discourage patients from receiving emergency care by such stratagems as requiring up-front payments. They’re also not allowed to charge patients who qualify for financial aid more than they would charge a typical insured patient.2 There are various ways this can be interpreted, according to the consumer advocacy organization Community Catalyst. Hospitals are required to publicize the policies far and wide—online and in print copies that are on display for patients and visitors.