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Contributed commentary by six-year cancer survivor Jessica Baladad:
I’ve been poked, prodded and cut more times than I can count. As a six-year breast cancer survivor, I thought I’d seen it all. But even I was shocked at the jab I recently received at a doctor’s appointment.
“Will you settle your overdue bill now — or later?” the front desk staff asked just loud enough for everyone in the waiting room to hear.
Millions of Americans struggle under the weight of medical debt. Nationwide, medical debt represents more than half of all debt in collections. Here in Tennessee, a 2019 Sycamore Institute study found that 1 in 4 residents with a credit report carry some amount of medical debt.
Worse, nonprofit hospitals that are supposed to serve the public good have become aggressive in their collection efforts. An investigation by MLK50 and ProPublica uncovered how Methodist Le Bonheur Healthcare, one of Tennessee’s largest nonprofit health care systems, sued more than 8,300 patients for unpaid hospital bills, including low-income patients that should have qualified for charity care or financial assistance.
Instead of easing the financial burden on patients, many non-profit hospitals in Tennessee have turned financial assistance programs into a moneymaker. Take one example: the federal 340B program.
Congress created the 340B Drug Pricing Program in 1992 as a way to make medications more affordable for low-income and rural patients. Over time, some hospitals in Tennessee figured out they could exploit the program. Hospitals take the big discounts on medications, and don’t pass those savings on to patients. Instead, they keep the money for themselves and charge us full price. According to an analysis by the Pioneer Institute, nearly half of the contract pharmacies intended to serve poor patients in Tennessee are located in affluent neighborhoods.
Most patients are unaware of whether we’ve been tagged as a 340B patient, receiving medications through a program intended to lower costs. This lack of transparency leaves patients in the dark about whether or not we are benefiting from the program.
When I got a recent hospital bill, I decided it was time to flip the script. I wanted to know: Did my nonprofit hospital get a big discount on my medication through the 340B program and then charge me full price?
Suddenly, my hospital wasn’t talking so loudly. Patients aren’t waiting around for an answer; we’re taking action. That’s why I’ve joined dozens of patient advocates to urge state lawmakers to support our “Patients Right to Know” campaign. We deserve to know if we are being tagged as a 340B patient and whether we’re getting the full discount on our medications. We also deserve to know how nonprofit hospitals are spending the savings from the 340B program. Are hospitals supporting charity care or other community services?
Accountability goes both ways. If hospitals are going to publicly shame patients and aggressively pursue patients in collections, we should have the right to know if nonprofit hospitals are fulfilling their end of the bargain.
You can join our Patients Right to Know campaign by visiting patientsright2know.com/tennessee.
Transparency in the 340B program is essential to restoring trust in our healthcare system and ensuring that hospitals are held accountable for their use of these savings. By requiring hospitals to disclose how they use 340B funds, we can ensure that these resources are benefiting Tennessee’s most vulnerable patients, as intended.
Jessica Baladad