Uncompensated care

Uncompensated care has been increasingly costing hospitals billions of dollars per year. Although these institutions may receive financial support from the government, reimbursements still fall short of covering the substantial costs incurred from bad debt and charity care (American Hospital Association, 2006; Vockrodt, 2007). What is more pressing though, are the dilemmas faced in providing such care to indigent patients.

Since it would be unethical to willingly compromise their welfare due to financial constraints, these dilemmas only serve to underscore how critical it is to sustain and more importantly, to improve assistance to institutions providing uncompensated care. Although uninsured/underinsured patients may turn to safety net institutions, such hospitals may already be overburdened with providing uncompensated care (Walker, 2005).

Thus medically indigent patients are left to choose between seeking free or subsidized help from safety net institutions whose resources are already strained and may therefore not be able to adequately attend to their needs, or take chances by seeking alternative approaches that are less costly but may not yet be clinically established methods of treatment. A patient’s financial problems therefore translate into ethical dilemmas for the attending physician – should patients be referred to safety net institutions even when there may be concerns over quality-of-care?

If the patient opts not to go to safety net providers but refuses standard tests and treatment due to cost, should the physician concede into lowering the standard of care? Due to the risk of incurring liabilities and malpractice charges, most would understandably be very hesitant about deviating from accepted methods of treatment and may instead resort to billing and claims adjustments just to help the patient cover medical expenses.

This however carries not only financial implications but more serious consequences as healthcare databases become compromised; future studies on which Medicare and Medicaid policies may be based might draw information from these databases, but due to inaccuracies from undercoding and false claims, the welfare of future patients may then be at stake (Weiner, 2001).

Thus, despite the negative financial implications on the healthcare system (Vockrodt, 2007), the cost of uncompensated care should not overshadow the associated ethical dilemmas and the medical needs of the indigent, since as with all other patients their welfare should likewise be the topmost of priorities.


American Hospital Association. (2006). Uncompensated hospital care cost fact sheet. Retrieved June 10, 2007, from http://www. aha. org/aha/content/2006/pdf/uncompensatedcarefs2006. pdf Vockrodt, S. (2007).

Unpaid bills put strain on hospitals. Retrieved June 12, 2007, from http://www. healthdecisions. org/News/default. aspx? doc_id=108849&source=rss Walker, D. M. (2005). Nonprofit, for-profit, and government hospitals: uncompensated care and other community benefits. Retrieved June 10, 2007, from http://www. gao. gov/new. items/d05743t. pdf%20 Weiner, S. (2001). “I can’t afford that! ”: Dilemmas in the care of the uninsured and underinsured. Journal of General Internal Medicine, 16(6), 412-418.

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