Why Healthcare Providers Are Cash Poor While Healthcare Costs Are High

The climbing cost of healthcare has been among2002,) the lowest level in a decade. Within that
the top issues in this year's elections, and it shoulduninsured working class, 20.6 million people were
be on your list of concerns too, because withinfull-time employees. Add in the fact that
the healthcare industry lies an immenselyemergency rooms are obligated to care for any
untapped potential for financing that is in dire needpatient that comes through their doors, regardless
of your cash flow expertise. Allow me to explainof whether they have insurance or not, and what
the situation and then show you where you fitdo you get? Answer: Millions of uninsured people
into the healthcare financial equation.who visit the emergency room to receive medical
According to the Agency for Healthcare Researchattention and who also rely on the hospital to foot
and Quality's Web site, the United States spendsthe bill.
a larger portion of its gross domestic productTo make matters worse, the U.S Census Bureau
(GDP) on healthcare (nearly one-seventh) thanreports that poverty rates have been steadily
any other major industrialized country, and it hasincreasing over the past few years (12.3 percent
been one of the fastest growing areas within thein 2002, translating to 34.6 million people, see
federal budget for the past several years. Infigure 1), forcing a majority of the less fortunate
other words, a large portion of all U.S. economicpopulation to either go uninsured or rely on
expenditures (14 percent or $1.2 trillion) is spentMedicaid to pay their medical bills. Neither option is
on providing healthcare to Americans. On thea promising solution to the healthcare cash crunch
surface, this appears to be a good thing becauseequation because the facilities cannot count on
if more money is budgeted for healthcare, thenbeing recompensed directly and adequately for
more people can benefit from it. Yet there's antheir obligated medical actions. Hence, the increase
underlying irony - an increasing number ofin uninsured Americans and those who rely solely
healthcare providers continue to operate in theon Medicaid and Medicare has had a tremendous
red. In fact, according to the American Hospitalaffect on the United States' healthcare institutions.
Association, one-third of America's 5,000-plusTitle XIX of the Social Security Act, commonly
hospitals are actually losing money, while anotherknown as the Medicaid program, is the largest
one-third is barely breaking even.source of funding for medical and health-related
So who's to blame for this financial crisis? Mostservices for America's poorest people. However,
would assume that healthcare institutions are thesince its launch in 1965, Medicaid's costs have
ones to blame. It is easy to jump to therapidly increased, paying an average of $3,935 per
conclusion that the institutions are abusing theperson to healthcare vendors in 2000, as reported
system and that they are not using their allottedby The Official U.S. Government Site for People
sums appropriately. However, in reality there arewith Medicare ( On the other hand, the Medicare
a number of culprits on the playing field, and onlyprogram was created in 1965 under title XVIII of
one of them is healthcare institutions. An agingthe Social Security Act. Designed to provide basic
population, an increasing number of uninsuredhospital and medical coverage for adults aged 65
Americans and slow-paying government aidand above who are no longer working and
programs all play a part in cramping the budgetstherefore are unable to pay for healthcare,
of hospitals, physicians, employers and consumers.Medicare's costs has also increased rapidly, and it
Over the past 50 years, our nation's populationcurrently covers 41 million Americans.
has aged significantly. The Baby Boomers areAlthough Medicaid and Medicare programs can be
quickly approaching their 65th birthdays, which willbeneficial for underprivileged and elderly Americans
place them in the oldest adult segment of thein need of healthcare, American medical
American population. (In fact, the U.S. Censusinstitutions and their vendors don't fare quite as
Bureau projects that over 20 percent of thewell in this cash crunch equation due to sluggish
American population will be included in the oldestand inadequate payments from the above federal
segment by 2050). According to The 2003programs.
Chartbook on Trends in the Health of Americans,Because each state has its own unique way of
the surge in elderly adults will place tremendousfiling for government healthcare coverage and
stress on America's healthcare system during thebecause of capped expense amounts, federal
21st century, because additional services will beinsurance plans like Medicaid and Medicare make
necessary to treat and manage their chronic andtheir payments slowly, sometimes taking months
acute health conditions. Not to mention there willto deliver funds and in many cases, the
be over 40 million retired elderly adults dependinggovernment-mandated payments don't cover the
solely on Medicare to cover their medical bills nextactual cost of providing care. Accordingly,
year, a problem that I will delve into later in thehealthcare institutions such as hospitals and nursing
article.homes take a longer time to pay their own
In addition to the 'baby boom' generation gettinginvoices. As a result of their inadequate financial
older, our younger generation has received theresources, these hospitals and nursing homes
short end of the stick when it comes tosuffer from dwindling human and technological
healthcare coverage. Medicaid usage and theresources. So in an effort to save money,
percent of uninsured Americans has been on thefacilities are forced to make cuts in staffing and
rise since 1984. The 2003 Chartbook on Trends inspecial treatment programs, pass on costly
the Health of Americans reported that in 2001,technological advances and start outsourcing more
adults aged 18-24 were most likely to lack healthgeneral positions, which creates a whole new
insurance coverage (16 percent went without forworld of vendors who sell to hospitals and nursing
the year) and those 55-64 were least likely. Inhomes. (Think: janitorial services, cafeteria
addition, the Denver Post reported that theworkers, temporary nurse staffing agencies,
number of uninsured young adults aged 25-34medical staffing and medical transcriptionists, to
"jumped dramatically" during 2003, from 9.8 millionname a few.)
to 10.3 million. Rising health insurance premiumsHealthcare institutions need money to help
and overall poverty rates have both contributedpatients, increase technology and pay their
to the 45 million Americans who went uninsuredvendors. But because it sometimes takes months
last year, as reported by The New York Times.for hospitals and nursing homes to be paid for
For example, expensive healthcare premiumstheir services, they are forced to take additional
make it harder for employers to afford coveragemonths to pay their own vendors for their
for their employees, creating an uninsured workingservices. In the meantime, those vendors suffer
class. According to the Washington Post, thebecause they can't make payroll or pay taxes. So
proportion of the working class who receivedthey reach out to healthcare factoring consultants
health insurance through their employers fell toto help them find a way to stabilize their cash
60.4 percent in 2003, (down from 61.3 percent inflow.