January 5, 2003

Current Health Care Issue in Dona Ana County: Who will pay for the Uninsured Working  Person’s Hospital care, now that City-County have Decided to Privatize Memorial Medical Center  (Prepared by Rose  M. Garcia & Dr. James M. Kadlecek)

 This county has been getting a free ride for many years thanks to MMC and the good doctors who have practiced there. MMC and the docs found ways to cover the costs of the medically needy and  uninsured essentially  by absorbing those costs into the rates of paying patients.

 We are NOT talking here about the “indigent” patients who are generally low income persons, not eligible for Medicaid. Patients approved as “indigent” are partially paid for via federal “sole provider” funding. We are also NOT talking about the very poor and some children because many of them are paid for by the Medicaid program (federal and state $), and we’re NOT talking about the elderly, since they have Medicare to cover most of their hospital costs.

 We ARE talking about working families who do not have health insurance. These are the folks who work at the discount stores, wait tables at restaurants, farm workers, construction laborers, etc.. These are good people who work hard and keep our local economy serviced, but who don’t receive health insurance at their jobs, and cannot afford to buy coverage. It has been estimated that at least 25% of the county’s population is uninsured, or 45,000 persons.

  Hospital care provided by MMC last year (July, 02 to June 30, 03) to Low Income Persons

I.                   11,736 “indigent” patients,  total billed charges of $28,897,996

II.                  2,900  “community benefit” a/k/a “charity” patients,  $6,516,777

III.             12,270  DAC “uncompensated” (uninsured) patients, $14,892,923

IV.                     84 non-res “uncompensated” patients,  $256,395

Total billed charges to Uninsured, Uncovered Patients     $50,564,061

Less discounted value of these services based on DAC Indigent reimbursement % of 72.2%

Means the total discounted value of these hospital services was $36,507,252

Amount provided to MMC from federal “sole provider” funds  $12,500,000

Amount the Hospital had to absorb: $24,000,000

 In the proposal accepted by City-County, Tennessee based Province Healthcare, Inc. has said they will provide service to the indigent assuming they will receive federal funds for doing so, but they have not agreed to serve and cover the costs of uninsured working families. Nor have they been specific about their definition of exactly  who qualifies as “indigent”, and under what process indigency shall be determined, or what categories of service would be provided.   Province has stated that they would continue MMC’s charity care policies, but of course, the application of these policies is in question. 

 Clearly, we have a moral obligation (and some assert a legal obligation) to provide hospital healthcare service to the uninsured. The question now for Dona Ana County and Las Cruces officials is:

WHO WILL PAY?