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Physicians speculate on charity care decline

Healthcare Strategist Trend Watch, April 7, 2006

Healthcare professionals have been buzzing about a recent study showing a decline in charity care over the past decade. Some blamed the increased number of integrated health systems, rising operating costs, and high workloads. Some used the data to tout the need for universal healthcare.

The study, conducted by the policy research group Center for Studying Health System Change in Washington DC, found the number of physicians providing charity care dropped from 76% in 1996-97 to 68% in 2004-05.

On the Physicians for a National Health Program website, President Don McCanne wrote that physicians operating in integrated health systems are offered little opportunity to provide charity care within their system, while physicians in larger group practices have less influence over the level of charity care provided by their group.

McCanne said a national health insurance program would eliminate the need for physician charity care. He added, "department stores do not provide free clothing to those unable to pay. Health insurers do not provide free healthcare to those unable to pay. Yet physicians often do provide free healthcare to those unable to pay. It is one of the reasons why practitioners of the healing arts are held in high esteem."

Richard L. Clarke, president and CEO of the Healthcare Financial Management Association, wrote on his organization's blog that "this study provides additional evidence of the serious breakdown of the system of cost shifting that for years supported charity care. With government and private payers increasingly unwilling to pay the 'hidden tax' for charity care, the ability and willingness of physicians and hospitals to provide this care is more limited."

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